Spiwak Rae, Lett Ronald, Rwanyuma Laurean, Logsetty Sarvesh
Community Health Sciences and Psychiatry, University of Manitoba, Canada.
Mc Gill University & University of British Columbia, Founder & International Director Canadian Network for International Surgery, Canada.
Burns. 2014 Nov;40(7):1292-9. doi: 10.1016/j.burns.2014.01.007. Epub 2014 Mar 28.
Standardized courses for the care of the burn patient have historically been developed in High Income Countries (HIC). These courses do not necessarily reflect the challenges and needs of Low Income Countries (LIC) and some components may not be relevant there (i.e. use of ventilators in a country that has no or very limited number of ventilators). We are developing a Burn Management Course for East Africa. This course was created and trialed in a LIC and subsequently a formal manual and course curriculum created. Recently the first iteration of the course was undertaken in a major regional burn centre in East Africa. We present participant feedback on the course content, and potential future directions for course development.
(1) To evaluate the ability of a standardized burn course for LIC to meet the needs of the participants. (2) To explore characteristics of burn care and needs related to delivery of burn care in LIC.
21 students participated in a multidisciplinary burn management course. They were asked to complete an anonymous questionnaire at the end of the course.
There were 11 nurses, 6 doctors, a physiotherapist, occupational therapist, and a dietician. 15 worked in either the adult or pediatric burn units, the other six worked in emergency, ICU or the operating room. The majority of respondents (56%) had less than 3 years of experience working with burn patients. Overall agreement that the course met their objectives was rated as 4.6 out of 5. As well the students agreement that they had a better understanding of burn injury was rated as 4.8/5. 55.6% indicated that scalds were the most commonly seen injury followed by 27.8% responding that flames were the most common. Some responses to the question of top difficulties facing the caregivers were similar to HIC: staffing shortages, bed shortages, and finding useable donor site in large burns. Other responses highlighted the challenges these care givers face: poverty stricken patients, not enough appropriate food available, and deficiencies in infection control practices.
It is possible to create a course that translates knowledge from a HIC setting to meet the needs of the end-user in a LIC setting.
历史上，高收入国家（HIC）开发了针对烧伤患者护理的标准化课程。这些课程不一定反映低收入国家（LIC）的挑战和需求，而且有些内容在低收入国家可能并不适用（例如，在一个没有或只有极少数呼吸机的国家使用呼吸机）。我们正在为东非地区开发一门烧伤管理课程。该课程在一个低收入国家创建并进行了试验，随后编写了正式的手册和课程大纲。最近，该课程的首次迭代在东非的一个主要地区烧伤中心开展。我们展示了参与者对课程内容的反馈以及课程未来可能的发展方向。
（1）评估针对低收入国家的标准化烧伤课程满足参与者需求的能力。（2）探索低收入国家烧伤护理的特点以及与烧伤护理提供相关的需求。
21名学生参加了多学科烧伤管理课程。课程结束时，他们被要求填写一份匿名问卷。
其中有11名护士、6名医生、一名物理治疗师、一名职业治疗师和一名营养师。15人在成人或儿科烧伤病房工作，另外6人在急诊科、重症监护室或手术室工作。大多数受访者（56%）烧伤患者护理工作经验不足3年。总体而言，认为该课程达到目标的认可度在5分制中被评为4.6分。学生们认为他们对烧伤损伤有了更好理解的认可度为4.8分（满分5分）。55.6%的人表示烫伤是最常见的损伤，其次27.8%的人认为火焰烧伤最常见。在护理人员面临的最大困难问题上，一些回答与高收入国家类似：人员短缺、床位短缺以及大面积烧伤时寻找可用的供皮区。其他回答则突出了这些护理人员面临的挑战：贫困患者、没有足够合适的食物以及感染控制措施存在缺陷。
有可能创建一门课程，将高收入国家的知识转化为满足低收入国家终端用户的需求。
