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Objective: To examine the effects of the transitional tele-rehabilitation programme on quality of life of adult burn survivors., Design: A prospective, single centre, randomised controlled trial and reported according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines., Participants: Adult burn survivors aged ≥18 years with burn size ≥10% total body surface area irrespective of the depth was considered eligible to participate., Intervention: The intervention was in two phases: pre-discharge and active follow-up phase (which occurred via WeChat). In both phases, comprehensive assessment and intervention guided by the Omaha System and evidenced-based protocols guided the care delivery over an 8-week period., Main Measures: The outcome of interest was quality of life. Two outcome measures were used to assess the outcome of interest: Burn Specific Health Scale-Brief (BSHS-B) and the EQ-5D-5L tools. The outcome was assessed at three time points: T0 (baseline), T1 (immediate post-intervention) and T2 (4 weeks from T1)., Results: In total, 60 adult burn survivors were randomly allocated to undergo the new programme. The transitional tele-rehabilitation programme elicited statistically significant improvement in simple abilities, affect, interpersonal relationship (T2) and overall quality life (T1 and T2) measured on the BSHS-B., Conclusion: Ongoing rehabilitative care is essential to support the recovery process of burn survivors considering that some quality-of-life subscales may improve faster than others. The study findings highlight the potential of employing a social media platform to improve post-burn quality of life outcomes., Trial Registration: ClinicalTrials.govNCT04517721. Registered on 20 August 2020., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Rehabilitative care for burn patients in developing countries is often wrought with several issues. Post-discharge support is equally challenging as there is often limited rehabilitative care as the burn survivors and their families transition. To inform practice, this study sought to explore the perspectives of adult burn survivors and burn care staff regarding transitioning from the burn unit and the development of a transitional rehabilitation programme. We employed interpretive description for this study. Semi-structured face-to-face interviews were conducted with adult burn survivors and burn care staff across two tertiary healthcare facilities in Lanzhou, Gansu Province of China, and Ghana. The thematic analytical approach was employed to analyse the data. Forty-six participants comprising 26 adult burn survivors and 20 burn care staff participated in this study. Two themes and five subthemes emerged from the data. Transitioning from the burn unit to the home was described as complex with varied biopsychosocial needs emerging. However, available support was not comprehensive to resolve these needs. Existing pre-discharge support is limited across both settings. Burn survivors expressed interest in taking on an active role in the rehabilitation process and being able to self-manage their post-burn symptoms following discharge. Transitional rehabilitative support should include an active follow-up system, ensure patient- and family-centred support, and offer a bundle of comprehensive rehabilitative services using locally available items which do not financially burden burn survivors and their families. In conclusion, transitioning from the burn unit is filled with varied health needs. Transitional rehabilitative care is required to bridge the pre-discharge and post-discharge periods., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The projected rise in health-related suffering warrants the integration of palliative care across all health systems. For traditionally non-palliative care settings, barriers and enablers to palliative care integration remain poorly understood. This study sought to explore these barriers and enablers in the Emergency and Burn Units across two healthcare facilities in the middle belt of Ghana using qualitative description. Thirty-nine healthcare staff comprising 20 burn care staff and 19 ED staff were purposively recruited and interviewed. Interviews were transcribed following which thematic analysis was performed inductively. Two themes and six subthemes emerged from the data. The Ghanaian socio-cultural context often crippled the discussion of death and dying. Overall, there is a perceived tension between emergency/burns and end-of-life care. Opportunities however exist to improve the situation which will require more work regarding curricula improvement, providing avenues for professional development, culturally sensitive communication, and identifying strategies of engaging relatives., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Although the culture in burns/critical care units is gradually evolving to support the delivery of palliative/end of life care, how clinicians experience the end of life phase in the burn unit remains minimally explored with a general lack of guidelines to support them., Aim: To explore the end of life care experiences of burn care staff and ascertain how their experiences can facilitate the development of clinical guidelines., Design: Interpretive-descriptive qualitative approach with a sequential two phased multiple data collection strategies was employed (face to face semi-structured in-depth interviews and follow-up consultative meeting). Thematic analysis was used to analyze the data., Setting/participants: The study was undertaken in a large teaching hospital in Ghana. Twenty burn care staff who had a minimum of 6 months working experience completed the interviews and 22 practitioners participated in the consultative meeting., Results: Experiences of burn care staff are complex with four themes emerging: (1) evaluating injury severity and prognostication, (2) nature of existing system of care, (3) perceived patient needs, and (4) considerations for palliative care in burns. Guidelines in this regard should focus on facilitating communication between the patient and family and staff, holistic symptom management at the end of life, and post-bereavement support for family members and burn care practitioners., Conclusions: The end of life period in the burn unit is poorly defined coupled with prognostic uncertainty. Collaborative model of practice and further training are required to support the integration of palliative care in the burn unit.