Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review

Abstract

<jats:title>Abstract</jats:title> <jats:p>Improvement in burn care has led to more patients surviving the injury but has also led to more burn survivors requiring rehabilitation for a protracted period after discharge. Thus, this review sought to map the intervention content and outcomes associated with existing post-discharge rehabilitation programmes for adults surviving major burns. A systematic scoping review approach was utilised. The Template for Intervention Description and Replication (TIDieR) and core outcome set for adult burn survivors were used to guide data extraction following which a narrative synthesis was undertaken. In all, 23 papers were retained in the review. Following discharge and up to 1year post-burn, the components of the rehabilitation programmes comprised of physical, psychological, and social components. Beyond 1year post-burn, the rehabilitation programmes demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programmes up to 1year post-burn covered the seven core outcome domains. Outcomes associated with rehabilitation programmes beyond 1year post-burn were however limited to the perceived quality of life, neuromuscular and physical role functioning domains. Although most studies reported statistically significant findings, the outcome measures varied across studies which makes it difficult to draw overarching conclusions. The findings suggest that long-term rehabilitation programmes for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programmes. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.</jats:p>

Adult Burn Survivors and Burn Care Staff Perceptions Regarding Transitioning From the Burn Unit: A Cross-Country Qualitative Study in Ghana and China

“…Developing countries bear a significant burden of burns, yet availability and access to rehabilitative care remains a significant challenge (Bayuo & Wong, 2021). Even with the existing services available on outpatient basis, findings from the current study suggest that they may not be comprehensive to meet the biopsychosocial needs of burn survivors and their families.…”

“…The complex and often protracted nature of the post-burn recovery process warrants ongoing rehabilitative care commensurate to emerging needs during transitioning and in the long term. Although this may be challenging particularly in developing countries due to resource constraints (Bayuo & Wong, 2021), it is possible to obtain contextual evidence that can guide the development and implementation of rehabilitation services. As mentioned earlier, similar challenges to burn care service provision such as limited rehabilitative care, burn care resource constraints, and poor follow-up support exist in Ghana and China.…”

Effects of a nurse-led transitional burns rehabilitation programme (4Cs-TBuRP) for adult burn survivors: protocol for a randomised controlled trial

“…Comprehensive follow-up system of care in the home/community is therefore greatly needed to promote rehabilitation of burn survivors [ 20 ]. It is worth mentioning that the home/community has been identified as a suitable location for the implementation of burn rehabilitation programmes which can enhance patient outcomes, particularly if the programme is structured and have active follow-ups on the burn survivor [ 21 ].…”

Effects of A Nurse-Led Transitional Burns Rehabilitation Programme (4Cs-TBuRP) For Adult Burn Survivors: Protocol for a Randomised Control Trial

“…Comprehensive follow-up system of care in the home/ community is therefore greatly needed to promote rehabilitation of burn survivors (20). It is worth mentioning that the home/ community has been identi ed as a suitable location for the implementation of burn rehabilitation programmes which can enhance patient outcomes, particularly if the programme is structured and have active follow ups on the burn survivor (21). Thus, to bridge the immediate predischarge and early post-discharge gap and improve patient outcomes, a nurse-led transitional burns rehabilitation programme (4Cs-TBuRP) has been developed following the Medical Research Council (MRC) Framework (22).…”