Bringing research to the bedside: Knowledge translation in the mental health care of burns patients

Abstract

Advances in surgical techniques and wound management have improved outcomes for burn patients; however, the psychological impacts on burn survivors have had less attention. There is a higher rate of mental health disorders amongst burns victims, with those with pre-existing mental health conditions likely to have worse outcomes. To implement effective burns care and rehabilitation, knowledge and understanding of mental health issues is required. This position paper discusses the extent to which clinicians currently translate knowledge around mental health and burns into practice to identify enables and inhibitors. Successful knowledge translation requires dissemination and accessibility of information with the capacity and readiness for change. Clinicians and researchers need to identify how translating research to practice can meet the needs of burn survivors. There is a gap in the utilization of evidence concerning mental health and the needs of burns survivors, and we need to understand what we know as compared to what we do. Clinicians are well placed to determine how and why knowledge does not necessarily translate to practice and how they can better accommodate the needs of burn survivors.

Qualitative research investigating the mental health care service gap in Chinese burn injury patients

“…The World Health Organization (WHO) has identified psychological rehabilitation as an essential and integral component of general health. The gap in mental health services among burn survivors in China prevails [ 25 ], and health professionals need to identify the underling barriers and translate research results into practice to meet the needs of burn survivors [ 26 ]. The present theoretical model found the overlapped barriers which prevented the burn survivors get the best psychological rehabilitation services, and the theoretical model also discovered that the underlying economic barrier is the decisive obstacle of mental health services gap.…”

Wounds in mental health care: The archetype of a ‘wicked problem of many hands’ that needs to be addressed?

“…It has been reported (Cleary et al, 2018;Hemingway et al, 2013) that the wound care of people experiencing mental ill health and who also have self-inflicted wounds or burns is particularly challenging for clinicians as there is some uncertainty about whether and how to deliver active wound care treatment to the patient in the context of also supporting the person to address the issues that have resulted in self-harm. In most cases when a person experiencing mental ill-health has self-inflicted burns the immediate focus is reported to predominantly focus on treating the burns injuries rather than on interventions to also promote psychological recovery (Cleary et al, 2018). In the immediate aftermath of self-inflicted burns, care may be led by specialist burns or tissue viability nurses who have limited insight into mental care and who prioritise burns treatment as they perceive the burns to be more imminently life threatening than a person's underlying mental ill health.…”

“…Comprehensive and holistic assessments are especially important in planning and delivering care to people experiencing mental ill health who also inject intravenous drugs as they ensure that additional factors relating to their drug use that impact on wound healing are taken into account in their treatment plans (Geraghty, 2015). Some have argued that the difficulties of people that have suffered self-inflicted burns can only be met through an evidence based, holistic approach to assessment and treatment in relation to their combined mental health and wound care needs (Cleary et al, 2018).…”

Health numeracy in research and clinical practice

“…There are also issues with the wider dissemination of health research to policy makers and the lay public, due to a limited capacity to understand the data. Effective knowledge translation requires minimizing inhibitors between researchers, clinicians, and the general public (Cleary et al, ), not least of which is the ability to communicate and comprehend quantitative research. Misleading or ambiguous presentation of quantitative information can lead to obfuscation of the ideas they are meant to carry.…”