Bayuo Jonathan, Wong Frances Kam Yuet
School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
J Burn Care Res. 2021 Aug 4;42(4):651-710. doi: 10.1093/jbcr/iraa110.
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 postdischarge rehabilitation programs for adults surviving major burns. A systematic scoping review approach was utilized. 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 1 year postburn, the components of the rehabilitation programs comprised of physical, psychological, and social components. Beyond 1 year postburn, the rehabilitation programs demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programs up to 1 year postburn covered the seven core outcome domains. Outcomes associated with rehabilitation programs beyond 1 year postburn 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 programs for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programs. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.
烧伤护理的改善使得更多患者在烧伤后存活下来，但也导致更多烧伤幸存者在出院后需要长期康复治疗。因此，本综述旨在梳理与现有针对重度烧伤成年幸存者的出院后康复项目相关的干预内容和结果。采用了系统的范围综述方法。利用干预描述与复制模板（TIDieR）以及成年烧伤幸存者的核心结局集来指导数据提取，随后进行叙述性综合分析。该综述共纳入23篇论文。在出院后至烧伤后1年期间，康复项目的组成部分包括身体、心理和社会方面。烧伤后1年以后，康复项目以物理治疗为主。纳入研究中未突出对家庭成员的支持。烧伤后1年内康复项目的结果涵盖了七个核心结局领域。然而，烧伤后1年以上康复项目的相关结果仅限于生活质量感知、神经肌肉和身体角色功能领域。尽管大多数研究报告了具有统计学意义的结果，但各研究的结局测量方法各不相同，这使得难以得出总体结论。研究结果表明，针对成年烧伤幸存者的长期康复项目不足。还需要更有力的研究来考察与烧伤康复项目相关的社区参与结果。烧伤的性质及其深远影响表明，康复应采用以患者和家庭为中心的方法。
