Dignity-related distress profiles in burn survivors: A latent profile analysis

Burn injuries and their sequelae, such as scarring and disfigurement, can severely compromise survivors' dignity through body image disturbance. Existing research on dignity in burn populations has predominantly employed variable-centered approaches, which may not capture the heterogeneous, multidimensional nature of dignity-related distress. Latent profile analysis (LPA), a person-centered method, allows for the identification of homogeneous subgroups within heterogeneous populations, thereby offering a more nuanced understanding of how distinct dimensions of dignity co-occur and influence patient outcomes.

To identify subtypes of dignity‑related distress among burn survivors using latent profile analysis (LPA) and to explore the influencing factors associated with these subtypes.

A single-center, cross-sectional observational study, conducted in strict accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

A total of 323 burn survivors from a burn center were assessed using the Patient Dignity Inventory (PDI), the Burn Specific Health Scale‑Brief (BSHS‑B), and the Hospital Anxiety and Depression Scale (HADS). LPA was applied to identify dignity‑based subgroups. Model fit was evaluated using multiple criteria including AIC, BIC, aBIC, entropy, LMR‑LRT, and BLRT. Posterior probabilities and classification accuracy were examined to ensure profile reliability. One‑way ANOVA, chi‑square tests, and multivariate logistic regression were used to examine subgroup characteristics and their associations with sociodemographic variables.

A three-profile model provided the best fit, comprising: "Preserved Dignity" (Profile 1, n = 69, 21.36%), "Dependency and Symptom Distress" (Profile 2, n = 135, 41.80%), and "Pervasive Psychosocial and Existential Distress" (Profile 3, n = 119, 36.84%). Gender, burn depth, BICU admission, burn location, quality of life, and depression were significant influencing factors for dignity‑related distress across different profiles of burn patients (p < 0.05).

This study offers a novel person-centered perspective on dignity-related distress in burn survivors, identifying heterogeneous profiles via latent profile analysis. These profiles enable stratified, dynamic interventions to alleviate distress, enhance dignity, and support reintegration.