Physical Rehabilitation and Mental Health Care After Burn Injury: A Multinational Study

Abstract

While remarkable improvements have been made to acute hospital burn care in recent decades, it is not matched by improvements in post-acute care, including physical rehabilitation and mental health. Progress in acute hospital treatment of burn survivors now highlights the next important step—addressing care once a patient leaves intensive treatment and is discharged to the community. Long-term physical rehabilitation and mental health services are vital to improving quality of life for burn survivors. Using qualitative methods, we apply the adapted Reeve framework to assess and compare post-acute physical rehabilitation and mental health care across thirteen countries on six continents. Twenty semi-structured interviews were conducted with burn surgeons and rehabilitation specialists. One major theme that emerged was the importance of training and resources to the quality of post-acute care. This exploratory study suggests the value of investing scarce resources in a range of low-cost interventions to improve follow-up burn care. One intervention identified here is short-term training in post-acute rehabilitation and mental health to upgrade and standardize best clinical practices to address as-yet unmet post-discharge needs of burn survivors.

Combat and Operational Stress Control: Application in a Burn Center

“…Indeed, recent literature from the burn-care community asserts a need for improving psychological outcomes for burn survivors [9]. Despite this call, the delivery of psychosocial support may be difficult because of staffing issues or other priorities such as wound care [10,11]. To help meet this need, we proposed that holistic interventions, derived from occupational therapy and incorporated in the US Army's Combat and Operational Stress Control (COSC) model, could enhance and augment the psychosocial care of burn survivors.…”