PurposeThis study aimed to understand rehabilitation nurses’ perceptions of research information, related barriers, and avenues for future research, specifically in those caring for individuals with burn injury, spinal cord injury, or traumatic brain injury.DesignQualitative semistructured interviews were conducted.MethodsEighteen interviews were conducted. A thematic network approach identified codes and developed basic, organizing, and global themes.ResultsResearchers identified factors that facilitated research uptake, determined organizational structures that support research culture, and described nurse engagement with literature.ConclusionsAlthough participants desired to engage with the research literature, they identified barriers including time constraints, heavy workloads, and lack of access. To facilitate research uptake, research must be easily accessible, be easily digestible, and include clinical practice recommendations. Research must expand its scope to address issues relevant to the rehabilitation population.Clinical RelevanceOur findings may be used to drive improvements in research competence, facilitate knowledge translation, and support evidence-based practice among rehabilitation nurses.

Background Expansion of telehealth insurance coverage is hampered by concerns that such coverage may encourage excessive use and spending. Objective The aim of this paper is to examine whether users of telehealth services rely more on other forms of outpatient care than nonusers, and to estimate the differences in payment rates. Methods We examined claims data from a large national insurer in 2017. We limited our analysis to patients with visits for 3 common diagnoses (N=660,546). We calculated the total number of visits per patient, overall, and by setting, and adjusted for patient- and county-level factors. Results After multivariable adjustment, telehealth-visit users, compared to nonusers, had 0.44 fewer visits to primary care, 0.11 fewer visits to emergency departments, and 0.17 fewer visits to retail and urgent care. All estimates are statistically significant at P<.001. Average payment rates for telehealth visits were lower than all other settings. Conclusions These findings suggest that telehealth visits may substitute rather than add to in-person care for some types of care. Our study suggests that telehealth visits may offer an efficient and less costly alternative.

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Clinical practice guidelines (CPGs) provide an efficient route from research to practice because they follow a prescribed, vetted process for evidence collection. CPGs offer underserved fields, such as burn rehabilitation, an accessible approach to reliable treatment. A literature search was performed using the terms “Burns AND CPGs AND Rehabilitation.” Three reviewers determined whether guideline development followed an established vetting process. “Rehabilitation” required evidence of treatment to improve, maintain, or restore human function and provide treatment to facilitate recovery. Only 160 articles were obtained and, after adding the term “functional outcome,” 62 remained for full-text review, of which 21 were eligible. When articles were scored for inclusion of both rehabilitation AND function or functional outcome AND guideline vetting, seven articles remained. One was community based. Nine articles had no recorded vetting process but addressed rehabilitation as an outcome. There is a paucity of CPGs relevant to clinical rehabilitation for burn survivors, likely a result of very few published intervention trials, rare randomized controlled trials addressing rehabilitation, absence of data to establish an evidence base for practice recommendations, an inadequate number of community-based intervention trials, and little patient input. It is likely that rehabilitation of burn survivors will improve if more people gain skills in meeting the needs of people with burn injury. An increase in trained professionals may lead to an increase in intervention trials and research to establish evidence for CPGs. People engaged in burn research have an opportunity to devise a systematic, generally agreed-upon approach toward evaluating burn patients and treatment outcomes that will permit data sharing across the world and assess patients throughout the acute and chronic phases of burn injury.

PURPOSE: This study examines psychosocial risk factors associated with hospitalization among community-dwelling older adults in the United States. METHODS: Using two waves of the National Health and Aging Trends Study from 2011 and 2015, we conducted descriptive and multivariate analyses of individual-level data from a nationally representative sample of 8,003 Medicare beneficiaries ages 65 and older. Associations between hospitalization and risk factors including social isolation, depression, and anxiety were assessed. Covariates included gender, race/ethnicity, age, region, insurance type, falls, and comorbidities. RESULTS: Overall, about 20.9% of older adults reported a hospitalization within the past year and 22.2% were socially isolated. The odds of hospitalization were higher for socially isolated adults (OR 1.17; p = .02), for depressed adults (OR 1.25; p = .01), and for individuals with anxiety (OR 1.25; p = .02). Individuals living in the Western region had lower odds of hospitalization (OR 0.71; p = .001), whereas men (OR 1.13; p = .03), those requiring assistance with activities of daily living (OR 1.48; p &lt; .001), and those having one (OR 1.41; p = .03) or more (OR 3.05; p &lt; .001) chronic health conditions had higher odds of hospitalization. CONCLUSION: Social isolation, depression, and anxiety represent significant psychosocial risk factors for hospitalization among community-dwelling older adults in the United States. Efforts to reduce health care costs and improve health outcomes for older adults should explore ways to strengthen social integration and improve mental health.