A survey on the current status of burn rehabilitation services in China
A survey on the current status of burn rehabilitation services in China
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DOI：
10.1016/j.burns.2012.06.016
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发表时间：
2013-03-01
期刊：
影响因子：
2.7
通讯作者：
Wu, Jun
中科院分区：
文献类型：
--
作者：
Chen, Jian;Li-Tsang, Cecilia W. P.;Wu, Jun
背景：在中国，烧伤创面治疗有很长的历史，但烧伤专科病房从1958年才成立。经过50多年的实践，全国在烧伤创面护理和手术方面取得了很大成就。然而，在烧伤康复方面，发展似乎很缓慢。为了解中国烧伤康复服务的现状，对全国各烧伤康复中心进行了调查。方法：全面调查烧伤中心的入院情况和人员配备情况；(2)康复服务的可获得性、烧伤康复治疗专职人员的数量和学历；(3)烧伤康复服务滞后的困难。调查通过电子邮件发送给了87个烧伤中心的负责人，他们被要求填写调查问卷并将其寄回。结果：共有39个烧伤中心(44.8%)对我们的调查做出了回应。这些中心分布在中国近70%的行政省份，因此，结果很好地代表了当前的烧伤护理体系。大多数中心已经认识到康复治疗的重要性，烧伤患者的预后已取得显着改善。有大量的烧伤患者需要康复治疗，但大多数中心面临康复治疗师短缺的问题，这显然可能导致为患者提供高质量的康复方案的困难。虽然康复治疗的时间比以前早得多，但在急性烧伤护理阶段仍未被广泛接受。越来越多的专家加入烧伤中心，成为专业烧伤团队的成员。然而，烧伤专科的专业教育和培训似乎很稀少。还有改进的空间。阻碍康复治疗进展的问题是：医务人员和公众缺乏康复知识，专业人员不足，这支队伍的学历相对较低，缺乏标准的康复治疗指南，政府缺乏资金。结论：经过20年的临床实践，康复理念已被接受，接受调查的大部分烧伤中心都开展了多种形式的康复技术。然而，结果也表明，烧伤中心的康复实践历史很短。加强康复服务的发展，以适应中国严重烧伤患者管理的需要。建议改善目前的烧伤康复服务，包括：(1)为烧伤外科医生、治疗师、护士以及患者、家属和公众提供康复教育；(2)建立康复治疗临床指导的标准指南；(3)建立跨学科的烧伤康复团队；(4)加强对烧伤患者身心结局的调查和研究；(5)从人员配备、资金和为烧伤幸存者提供保险等方面实施管理措施。(C)2012年爱思唯尔有限公司和ISBI。版权所有。
Background: In China, there is a very long history of burn wound treatment, but the specialised burn care units were set up only from 1958. With more than 50 years of practice, great achievements have been made in burn wound care and operations in the country. However, in terms of burn rehabilitation, the development appears to be slow. In order to determine the current status of burn rehabilitation services in China, a survey was conducted to various burn centres in China.Methods: A comprehensive survey was conducted as well as to collect data related to (1) the admissions and staffing of the burn centres; (2) availability of rehabilitation services, number and educational background of specialised personnel dedicated in burn rehabilitation therapy; and (3) the difficulties leading to the lag of the burn rehabilitation services. The survey was sent to the chiefs of 87 burn centres via e-mail and they were requested to fill out the survey questionnaire and to send it back. For those who did not respond within 1 month, a reminder was sent.Results: There are totally 39 (44.8%) burn centres responding to our survey. These centres were geographically distributed in nearly 70% of the administrative provinces in China; hence, the results could well represent the current burn care system. Most centres have recognised the importance of rehabilitation therapy and remarkable improvements of outcome in burn patients have been achieved. There are a very huge number of burn patients that need rehabilitation therapy, but most centres face the problems of shortage of rehabilitation therapists, which apparently could lead to the difficulties in delivering a quality rehabilitation programme for patients. Although the time of rehabilitation therapy is instituted far earlier than before, it is still not widely accepted in the acute burn care stage. There are more specialists joining the burn centre and becoming members of the professional burn team. However, professional education and training in the burn specialty appear to be sparse. There is room for improvement. Problems that impede the progress of rehabilitation therapy are: lack of rehabilitation knowledge in medical staff as well as the public, the shortage of specialised personnel and relatively low educational background of this team, lack of standard guidelines for rehabilitation treatment instructions and lack of funding from the government.Conclusion: After 20 years of clinical practice, rehabilitation concepts are well accepted and many forms of rehabilitation techniques are carried out in most burn centres that responded to the survey. Yet, the results also indicate that there is a short history of rehabilitation practice among the burn centres. There is a burning need to enhance the development of rehabilitation services so as to meet the demands of management of severely burned patients in China. Some suggestions are made to improve the current burn rehabilitation services which would include: (1) provide rehabilitation education programmes for burn surgeons, therapists, nurses, as well as patients, families and the public; (2) set up standard guidelines for clinical instruction of rehabilitation therapy; (3) build an interdisciplinary burn team; (4) more investigation and research on the physical and psychological outcomes of burn patients; and (5) implement administrative measures in terms of staffing, funding and offering insurance to burn survivors. (C) 2012 Elsevier Ltd and ISBI. All rights reserved.