Authors (including presenting author) :
LIU SK (1)
Affiliation :
Burn Unit, Department of Surgery, Queen Mary Hospital, HKWC
Keyword 3: :
Self management
Introduction :
With the advancement of medical technology, the prognosis of individuals suffering from burn injuries has improved. Burns represent not only a serious illness but also a traumatic event with significant adverse potential for developing complex physical and mental problems. Burn survivors need to adapt to a new situation after discharge as they return to the community and assume full responsibility for their care. However, limited support or information are provided to local burn survivors, which may lead to poor treatment compliance, worsening scar outcomes thus inducing suboptimal quality of life.
Objectives :
i) To explore the facilitators or barriers encountered during aftercare from the perspective of burned patients and healthcare professionals. ii) To investigate the feasibility of self-management education on quality of life in adults burn at aftercare
Methodology :
A mixed-method approach was used to understand burn patients’ health care needs in qualitative approach. This data was integrated into quantitative research at later stage. A single-blinded pilot randomized controlled trial was conducted in one regional burn unit to examine the efficacy of mobile-assisted self-management education. Total of 50 participants were recruited with 25 participants assigned to each group. Control group received usual care while intervention group received two additions, 30 minutes per session, individual, face-to-face self-management education before discharge and follow up phone calls after discharge. Both groups were able to use instant messaging for any inquiry. Generic and burn specific quality of life (QoL), self-efficacy, itchiness score, pain scores and rehabilitation knowledge were collected at different time points (upon discharge, post 1 month & post 3 months).
Result & Outcome :
Regarding qualitative findings, standardized training & information should be considered upon discharge. Accessible support and tailor-made education could help burn patients in recovery. For pilot trial, total 50 participants were recruited from one local burn unit and allocated into control group and intervention group. Mixed effect model was used to analyze the differences between two groups with repeated measures and also to account for both fixed effects and random effects. No statistical significance in sociodemographic characteristics between groups was noted except burn etiology. For primary outcome, we noted that BSHS-B(p=0.001) & EQ-5D-5L (p=0.032)have significant changes between groups over time. For secondary outcomes, self-efficacy(p=0.002), pain level(p=0.004) and rehabilitation knowledge(p=0.01) have improved significantly, no significant difference in itchiness level(p=0.401). The intervention was observed to have an indirect effect on improving the quality of life of burn patients by increasing participants’ self-efficacy. All outcomes are found to be improved over time. Burn recovery is a complex process and not linear. This is the first local findings about healthcare needs in burn patients and impact of mobile assisted self-management education. Mobile assisted self-management education could provide significant improvement in quality of life, self efficacy, burn rehabilitation knowledge and pain level. Longer follow up and scar assessment tools are suggested to include in future studies.
