Patient selection: burn patient
Items:
(1) uncomfortable in the presence of family
(2) uncomfortable in the presence of friends
(3) uncomfortable in the presence of strangers
(4) satisfied with overall appearance
(5) satisfied with appearance of scalp
(6) satisfied with appearance of face
(7) satisfied with appearance of neck
(8) satisfied with appearance of hands
(9) satisfied with appearance of arms
(10) satisfied with appearance of legs
(11) satisfied with appearance of chest
(12) appearance interferes with relationships
(13) feel burn is unattractive to others
(14) don't think people would want to touch me
|
Response
|
Points for Items 1 to 3 and 12 to 14
|
Points for Items 4 to 11
|
|
strongly disagree
|
1
|
7
|
|
disagree
|
2
|
6
|
|
slightly disagree
|
3
|
5
|
|
neither agree or disagree
|
4
|
4
|
|
slightly agree
|
5
|
3
|
|
agree
|
6
|
2
|
|
strongly agree
|
7
|
1
|
total score =
= SUM(points for all 14 items)
Interpretation:
• minimum score: 14
• maximum score: 98
• The higher the score the greater the dissatisfaction with appearance.
percent of maximum dissatisfaction =
= ((score) - 14) / 74 * 100%
