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对儿科烧伤患者及其照顾者而言最重要的结果是什么:短期与长期优先事项的比较

What Outcomes Matter Most to Paediatric Burn Patients and Their Caregivers: A Comparison of Short-Term and Long-Term Priorities.

作者信息

Spronk Inge, Edgar Dale W, Shoesmith Victoria, Lansdorp Corine A, Fear Mark W, Wood Fiona M, Martin Lisa J

机构信息

Dutch Burns Foundation, 1941 AJ Beverwijk, The Netherlands.

Association of Dutch Burn Centres, Maasstad Hospital, 3007 AC Rotterdam, The Netherlands.

出版信息

Eur Burn J. 2024 Oct 22;5(4):369-388. doi: 10.3390/ebj5040033.

Abstract

Identifying outcomes that matter most is key in driving specialized paediatric burn care. The aim of this study was to discover the most important outcomes for paediatric burns. Parents of children (0-3 year and 4-11 years old) and adolescents (12-17 yearss old) completed surveys to identify outcomes that matter most in the short-term (<6 months postburn) and long-term (6-24 months postburn). The percentage of patients scoring an outcome as 'very important' was used to rank the outcomes. Fifty-four parents/adolescents participated (response rate: 27%). Children had a median TBSA burned of 5.0% (IQR: 2.0-7.0%). In the short-term, 'good wound healing' and 'no wound infection' (both at 71.4-100%) were very important for all children. 'Not having pain' (90.3-93.8%) was ranked highest for children ≤11 years old, whereas 'walking or moving around' (85.7%) was most important for older children. In the long-term, more variation was seen in outcome priorities; however, both 'not having pain' (53.6-85.7%) and 'flexibility of scar(s)' (60.7-71.4%) were considered very important by all three groups. Patient- and parent-derived priorities are important for developing consumer-centric, highest-value care pathways. The priority of the outcomes identified is a starting point to discuss treatment options and recovery priorities in a family-centric approach to guide high-value, individualized care.

摘要

确定最重要的结果是推动专业儿科烧伤护理的关键。本研究的目的是发现儿科烧伤最重要的结果。0至3岁、4至11岁儿童以及12至17岁青少年的父母完成了调查,以确定在短期(烧伤后<六个月)和长期(烧伤后6至24个月)最重要的结果。将将某一结果评为“非常重要”的患者百分比用于对结果进行排名。54名父母/青少年参与了调查(回复率:27%)。儿童烧伤的总体表面积中位数为5.0%(四分位距:2.0 - 7.0%)。在短期内,“伤口愈合良好”和“无伤口感染”(两者均为71.4 - 100%)对所有儿童都非常重要。“无疼痛”(90.3 - 93.8%)在11岁及以下儿童中排名最高,而“行走或四处活动”(85.7%)对年龄较大的儿童最为重要。在长期,结果优先级的差异更大;然而,“无疼痛”(53.6 - 85.7%)和“瘢痕灵活性”(60.7 - 71.4%)在所有三个组中都被认为非常重要。患者和家长确定的优先级对于制定以消费者为中心、最高价值的护理路径很重要。所确定结果的优先级是一个起点,以便以家庭为中心的方法讨论治疗选择和恢复优先级从而指导高价值的个性化护理。

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