Impact of Work-Related Burn Injury on Social Reintegration Outcomes: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

Nursing the burn-injured patient and supporting his/her family throughout recovery is a complex, demanding, but ultimately, rewarding professional role. The repertoire of nursing skills is varied and includes comprehensive critical care, complex wound care, pain and anxiety management, psychosocial support and community re-integration. Nurses are a consistent presence throughout all phases of a patient’s care, including arrival in the emergency department, time in the critical care unit, transfer to a burn unit/center, repatriation to a community hospital, transfer to a rehabilitation facility, and discharge to an outpatient burn clinic. Burn nursing care continues to be driven by evidence-based practices in burn care and improved upon by both quantitative and qualitative nursing research. This book chapter on “Nursing Management of the Burn Patient” is intended to assist the nurse in providing comprehensive care to the burn patient and his/her family.

Nursing Management of the Burn Patient

INTRODUCTION
Participation in work and employment is a milestone of adulthood. People returning to work after burn injury may have physical, psychological, social, and environmental barriers to overcome in order to resume their pre-injury employment. The aim of this paper is to evaluate qualitative findings regarding return-to-employment after burn injury.


METHODS
A qualitative synthesis was conducted based on the qualitative findings of an earlier mixed methods review. A pre-determined scoping review protocol was used in the earlier review to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT, and CDSR databases between 2000 and Aug 2021. Any papers presenting qualitative data from previously employed adults with cutaneous burn injuries were included.


FINDINGS
A total of 20 papers with qualitative data on return-to-employment after burn injury were found. Only six included studies focused on return-to-employment outcomes and the remaining studies reporting on quality of life and life experiences after burn injury. Common themes included impairments that develop and change over time; occupational identity and meaning; temporal aspects of burn recovery; burn rehabilitation services and interventions; attitudes, knowledge and support of service providers; workplace environments supporting work re-engagement after burn injury; usefulness of work accommodations; family and social supports, individuals attributes that influence re-engaging in employment; and accepting and rebuilding.


CONCLUSION
Resumption of work after burn injury is regarded as a key marker of recovery for working-aged adults by burn survivors and burn care professionals. Support at transition points during the burn recovery process and peer-led programmes were important. However, limited information currently exists regarding clinical practices, service gaps, and understanding of return-to-employment outcomes after burn injury.

Understanding return-to-employment experiences after burns: Qualitative scoping review findings.

Evaluation of effectiveness of a social reintegration program following a burn injury

Returning to work can be challenging for burn survivors. Approximately 28% never return to any form of employment, resulting in lower health-related quality of life. Open communication has been identified as a facilitator for return to work (RTW). To ease the RTW process and promote communication with coworkers and employers a knowledge translation (KT) intervention was developed for burn survivors. Following its implementation, the impact on the RTW process was evaluated. This study was a cross-sectional, mixed methods study where burn survivors included in the KT intervention were compared with a control group. Control group participants were selectively invited so that the two groups' mean age, sex, and percent total body surface area burned were similar. Semistructured interviews gathered information about their RTW process and outcomes. Qualitative data were analyzed through thematic analysis and quantitative data were summarized and compared using Mann-Whitney tests. Overall, both groups were satisfied with their RTW process. Participants from the control group identified more barriers related to support received, particularly at work, and reported more psychological symptoms such as posttraumatic stress disorder, self-consciousness, and discomfort with questions. Many participants from the KT group indicated the KT intervention gave them tools and information to provide others with a better understanding of their lived experience. It is possible that the KT intervention facilitated more open communication by empowering burn survivors to explain their situation on their own, thus reducing the prevalence of social and psychological barriers by allowing them to self-advocate for more support.

Perceived Value of a Knowledge Translation Intervention Designed to Facilitate Burn Survivors' Work Reintegration.

Barriers and facilitators to work reintegration and burn survivors' perspectives on educating work colleagues.

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Barriers and facilitators to work reintegration and burn survivors' perspectives on educating work colleagues.