Emotional Reactivity and Emotion Regulation in Relation to Health-Related Quality of Life After Burn Injury: A Cross-Sectional Observational Study

Introduction: Burn severity alone may not explain differences in health-related quality of life (HRQoL) after burn injury. We examined whether emotional reactivity and emotion-regulation strategies were associated with HRQoL beyond burn severity. Methods: This cross-sectional study included 256 adults with burn injury treated at the Vietnam National Burn Hospital (2024–2025). Total body surface area (TBSA) and burn depth represented severity. Emotional reactivity and emotion-regulation strategies were assessed using the Emotion Reactivity Scale (ERS) and Emotion Regulation Questionnaire-Short Form. Burn-specific and generic HRQoL were assessed using the Burn-Specific Health Scale–Brief (BSHS-B) and EuroQol five-dimensional five-level (EQ-5D-5L). Results: TBSA was positively associated with ERS (r = 0.30, p < 0.001), whereas burn depth was not (p = 0.18). Higher ERS was associated with poorer BSHS-B Function (r = −0.34), Affect and Relations (r = −0.39), Skin Involvement (r = −0.28), and EQ-5D-5L (r = −0.32; all p < 0.001). Cognitive reappraisal showed positive, whereas expressive suppression showed negative associations with HRQoL. In hierarchical regression for BSHS-B Affect and Relations, psychosocial variables increased adjusted R2 from 0.168 to 0.291 (Δadjusted R2 = 0.123, p < 0.001). Conclusions: Emotional reactivity and emotion-regulation strategies were associated with HRQoL and provided additional explanatory information beyond burn severity, supporting their consideration in individualized rehabilitation.