Burn Specific Health Scale -Brief (BSHS-B)

Introduction[edit | edit source]

Patient reported outcome measure.jpg

The Burns Specific Health Scale-Brief (BSHS-B) questionnaire is an appropriate measurement tool for the assessment of general, physical, mental, and social health aspects of the burn survivor. [1] It is commonly used to quantify the recovery of quality of life (QoL) after a burn.[2] In  response  to  the  lack  of  a specific  instrument  to  assess  the  health  of patients  with  burns,  Blades  et  al.  in  1979 recorded  the  first  114-item  version  of BSHS-Abbreviated (BSHS-A)  instrument[3];  and  after  its construction,  modified  versions  of  BSHS-Reviewed (BSHS-R)[4]  and  a  short  version  of  BSHS-B were  created. [5]

Intended Population[edit | edit source]

To measure burn specific health outcomes in survivors of burn injury, [5]

Scoring[edit | edit source]

The instrument measures psychosocial difficulties and physical difficulties using nine domains (Table 1). The participant is asked to choose from a 5-point scale of severity, where “0” is extreme and “4” is none at all. It has a total obtainable score of 40. [6]

Table 1: Domains of the Burn Specific Health Scale -Brief (BSHS-B)[6]
Physical(8) Burn specific (10) Social and emotional (22)
Hand function(5) Heat specificity (5) Affect (7)
Simple abilities (3) Treatment regimens (5) Work (4)
Sexuality (3)
Interpersonal relationship (4)
Body image (4)

The 40-item questionnaire, aims to assess QOL specific to postburn topics, requires about 15 minutes to complete. Higher BSHS-B score indicates fewer problems and, accordingly, a higher QoL.[6]

Evidence[edit | edit source]

Reliability and validity[edit | edit source]

Internal consistency of the BSHS-B has been shown to be excellent with a Cronbach's factor alphas ranging between 0.75-0.93.[5] There is evidence of concurrent validity for the BSHS-B when compared with the abbreviated and revised versions.[7] It is claimed that the BSHS-B exhibits construct validity in its association with a variety of aspects of burn-related health.[8][9]

The BSHS-B has been used to establish criterion validity for the QuickDASH in an Australian sample with upper limb burns and it was found that while mean scores improved over the period of the study for both measures, the effect sizes were greater for the QuickDASH.[10] When used in conjunction with the SF-36, the BSHS-B was found to provide more useful information regarding fear-avoidance and post-traumatic stress disorder in relation to return to work.[11]

References[edit | edit source]

  1. Kvannli L, Finlay V, Edgar DW, Wu A, Wood FM. Using the Burn Specific Health Scale-Brief as a measure of quality of life after a burn—What score should clinicians expect?. Burns. 2011 Feb 1;37(1):54-60.
  2. Edgar DW, Katsu A, Group AAH. Burn survivor rehabilitation: principles and guidelines for the allied health professional. In: Edgar DW, editor. ANZBA concensus document. Brisbane, Queensland, Australia: Australian and New Zealand Burns Association; 2007.
  3. Blades  B,  Mellis  N,  Munster  AM.  A burn  specific  health  scale.  The  Journal  of trauma 1982;22(10):872-5.
  4. Blalock  SJ,  Bunker  BJ,  DeVellis  RF. Measuring  health  status  among  survivors  of burn  injury:  revisions  of  the  Burn  Specific Health  Scale.  The  Journal  of  trauma 1994;36(4):508-15.
  5. 5.0 5.1 5.2 Kildal  M,  Andersson  G,  Fugl-Meyer AR, Lannerstam K, Gerdin B. Development of a  brief  version  of  the  Burn  Specific  Health Scale  (BSHS-B).  The  Journal  of  trauma 2001;51(4):740-6. Blades B, Jones C, Munster A. Quality of life after major burns. J Trauma 1979;19:556–8.
  6. 6.0 6.1 6.2 Murphy ME, Holzer CE, Richardson LM, Epperson K, Ojeda S, Martinez EM, Suman OE, Herndon DN, Meyer WJ. Quality of Life of Young Adult Survivors of Pediatric Burns Using World Health Organization Disability Assessment Scale II and Burn Specific Health Scale-Brief: A Comparison. J Burn Care Res. 2015 Sep-Oct;36(5) 521-533. doi:10.1097/bcr.0000000000000156. PMID: 25167373; PMCID: PMC4362787.
  7. Kildal M, Andersson G, Gerdin B. Health status in Swedish burn patients: Assessment utilising three variants of the Burn Specific Health Scale. Burns. 2002 Nov 1;28(7):639-45.
  8. Willebrand M, Kildal M. A simplified domain structure of the burn-specific health scale-brief (BSHS-B): a tool to improve its value in routine clinical work. Journal of Trauma and Acute Care Surgery. 2008 Jun 1;64(6):1581-6.
  9. Wikehult B. Use of healthcare, perceived health and patient satisfaction in patients with burns (Doctoral dissertation, Universitetsbiblioteket).
  10. Wu A, Edgar DW, Wood FM. The QuickDASH is an appropriate tool for measuring the quality of recovery after upper limb burn injury. Burns. 2007 Nov 1;33(7):843-9.
  11. Dyster-Aas J, Kildal M, Willebrand M. Return to work and health-related quality of life after burn injury. Journal of rehabilitation medicine. 2007 Jan 5;39(1):49-55.