NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
BMJ Open. 2023 Feb 10;13(2):e059528. doi: 10.1136/bmjopen-2021-059528.
This qualitative study aimed to investigate: (1) priorities of patients and healthcare professionals during recovery from a burn injury, (2) how priorities change over time and (3) how priorities map to outcomes currently reported in burns research.
Semi-structured interviews were conducted. Interviews were audio recorded, transcribed and analysed thematically.
SETTING, PARTICIPANTS: A total of 53 patients and healthcare professionals were recruited from four National Health Service (NHS) burn services across England and Wales across England and Wales. Patient participants (n=32) included adults, adolescents and parents of paediatric patients, with a variety of burn injuries in terms of severity and cause of burn injury. Healthcare professionals (n=21) were NHS staff members involved in burn care and included professionals with a range of clinical experience and roles (eg, nurses, surgeons, occupational therapists, physiotherapist, administration).
Ten themes relating to priorities (outcomes) during recovery from a burn injury were identified for patients and professionals. Of those, six were identified for patients and professionals ('pain and discomfort', 'psychological well-being', 'healing', 'scarring', 'function', 'infection'), three were unique to professionals ('patient knowledge, understanding and support', 'sense of control', 'survival') and one was unique to patients ('uncertainty'). Results highlighted that importance of these priorities changes over time (eg, 'survival' was only a concern in the short term). Likewise, priorities differed between patients and professionals (eg, 'pain' was important to patients throughout their recovery, but not for professionals). Seven out of 10 themes overlapped with outcomes commonly assessed in burn research.
Professionals' and patients' priorities (important outcomes) change over time after burn injury and differ between those groups. Burn care research should consider measuring outcomes at different time points during the recovery from a burn injury to accurately reflect complexity of burn recovery.
本定性研究旨在调查：（1）烧伤康复过程中患者和医疗保健专业人员的优先事项，（2）这些优先事项随时间的变化，以及（3）这些优先事项与烧伤研究中目前报告的结果之间的关系。
进行了半结构化访谈。访谈进行了录音、转录，并进行了主题分析。
地点、参与者：从英格兰和威尔士的四家国民保健服务（NHS）烧伤服务机构共招募了 53 名患者和医疗保健专业人员。患者参与者（n=32）包括成年人、青少年和儿科患者的父母，他们的烧伤严重程度和烧伤原因各不相同。医疗保健专业人员（n=21）是参与烧伤护理的 NHS 工作人员，包括具有各种临床经验和角色的专业人员（例如护士、外科医生、职业治疗师、物理治疗师、行政人员）。
确定了患者和专业人员在烧伤康复过程中优先考虑的十个与结果（结局）相关的主题。其中，六个主题是患者和专业人员共同关注的（“疼痛和不适”、“心理健康”、“愈合”、“瘢痕”、“功能”、“感染”），三个主题是专业人员特有的（“患者的知识、理解和支持”、“控制感”、“生存”），一个主题是患者特有的（“不确定性”）。结果表明，这些优先事项随时间而变化（例如，“生存”只是短期内的关注重点）。同样，患者和专业人员的优先事项也不同（例如，“疼痛”对患者在整个康复过程中都很重要，但对专业人员来说则不然）。十个主题中有七个与烧伤研究中通常评估的结果重叠。
烧伤后，专业人员和患者的优先事项（重要结果）随时间而变化，并且在这两个群体之间存在差异。烧伤护理研究应考虑在烧伤康复过程中的不同时间点测量结果，以准确反映烧伤康复的复杂性。
