| Objective: 1.To evaluate the status and influencing factors of acceptance of disability,hope,social participation and quality of life of burn patients who one month,three month and six month discharged from hospital.2.To describe the variation trend of acceptance of disability,hope,social participation and quality of life of burn patients within six months of discharge.Methods: 1.Using longitudinal study design,216 patients with burns were recruited in Fujian provincial burn center between September 2016 to May 2017 by convenience sampling method.We investigated these participants before the date of discharge from hospital,and explain the purpose of this study,the patients and their families to agree and sign the informed consent.Nurse and researcher do health education and inform patients discharged a month back to the hospital for return visit.Using telephone,Internet(QQ or We Chat)and outpatient review to collected data after hospital for one month,three months and six months after discharge.2.The theoretical framework is the ICF interaction,using the self-designed Demographic data and Disease Condition Questionnaire,the Acceptance of Disability Scale-Revised(ADS-R),the Herth Hope Scale(HHI),and he IPA questionnaire,Burn Specific Health scale-brief(BSHS-B),the Modified Barthel Index(MBI)Rating Scale and the Visual Analogue Scale(VAS)to investigate general information,acceptance of disability,hope,social participation,quality of life,itching condition,pain level and rehabilitation confidence.3.Using SPSS20.0 statistical software for data analysis,descriptive analysis was to used to describe general information,acceptance of disability,hope,social participation,quality of life,activity of daily life,itching condition and pain condition.T-tests,one-way ANOVA and Multivariable linear regression were used to describe the difference of ADS,HHI,IPA and BSHS-B between patients with different characteristics.Pearson correlation analysis was used to analyze the relationship between acceptance,hope,social participation and quality of life.Repeated measures was used to analyze the longitudinal changes of four time points of acceptance of disability,hope,social participation and quality of life.Results: 1.207 patients finally completed the whole procedure,with 9 patients missing during the follow-up,and the rate of loss follow-up is 4.2%.2.The ADL of burn patients when discharged from hospital was(80.38±17.80),the score of 1-month was(88.24±15.96),the score of 3-month was(91.46±14.16),the score of 6-month was(93.14±13.04).The ADL average of four points shows upward trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).The itching average of four points shows upward trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).The pain average of four points shows declining trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).The rehabilitation confidence four points shows upward trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference of the point of discharged from hospital and 1-month discharged from hospital was not statistically(P>0.05),the difference of other time points was statistically significant(P < 0.05).3.The ADS score of burn patients when discharged from hospital was(70.37±19.04),the score of 1-month was(72.44±19.87),the score of 3-month was(75.83±20.02),the score of 6-month was(77.36±20.33).The ADS average of four points shows upward trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).Multivariable linear regression shows financial state,occupation,severity of burns,sequela of burns,ADL level and pain level were main influencing factors of acceptance of disability of burn patients,which explained 57.9% of the variance.4.The HHI score of burn patients when discharged from hospital was(31.25±7.76),the score of 1-month was(31.57±7.45),the score of 3-month was(32.77±7.42),the score of 6-month was(33.34±7.58).The HHI average of four points shows upward trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).Pearson correlation analysis shows acceptance of disability and hope were positively correlated(r=0.5~0.8,P<0.01).Multivariable linear regression shows financial state,working condition,ADL level,itching level and rehabilitation confidence were main influencing factors of hope of patients with burns,which explained 64.2% of the variance.5.The IPA score of burn patients 1-month discharged from hospital was(53.26±18.44),the score of 3-month was(50.77±18.02),the score of 6-month was(43.88±19.21).The IPA average of four points shows declining trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).Pearson correlation analysis shows acceptance of disability,hope and social participation were negatively correlated.Multivariable linear regression shows financial state,severity of burns,ADL level,pain level,acceptance of disability and interconnectedness were main influencing factors of social participation of patients with burns,which explained 73.0% of the variance.6.The BSHS-B score of burn patients when discharged from hospital was(102.27±36.25),the score of 1-month was(110.83±35.96),the score of 3-month was(118.49±37.01),the score of 6-month was(121.93±36.87).The BSHS-B average of four points shows upward trend,the difference was statistically significant(P < 0.05),compared in pairs,the difference was statistically significant(P < 0.05).Pearson correlation analysis shows acceptance of disability,hope,social participation and quality of life were positively correlated.Multivariable linear regression shows inhalation injury,itching level,ADL level,rehabilitation confidence,acceptance of disability and social participation were main influencing factors of quality of life of patients with burns,which explained 79.2% of the variance.Conclusion:1.The ADL level and rehabilitation confidence was gradually increased over time at four time points,itching score and pain score was gradually declined over time at four points,which remind medical staffs are supposed to take effective intervention at sensitivity time points to improve ADL and rehabilitation confidence level and alleviate itching and pain condition.2.At four time points,the acceptance of disability of burn patients at the medium to low level.Medical staff should pay more attention to status of acceptance of disability related burn patients with severity or extremely serve burns,with squela of burns,great itching,financial situation or manual labour,provide target intervention program by changing cognition,relieving itching reaction and improving daily activities,promote patients body function recovery and psychosomatic rehabilitation.3.The hope of patients with burns at four time points at the medium to high level.Medical workers are supposed to pay more attention to status of hope status related burn patients with financial difficulty,losing job and great itching,provide effective psychological intervention program by improving physical symptoms and ADL level and rehabilitation confidence with burns to improve hope level.4.The social participation of burn patients at the bad-general level at 1-month and 3-month after discharged from hospital,at 6-moth after discharge,the social participation at general-good level.Medical staff are able to pay more attention to status of social participation related burn patients with severity or extremely serve burns and economic difficulty,provide target effectual intervention by improving rehabilitation confidence,ADL level,acceptance of disability,and promoting the importance of seeking external resources and receiving strong support in order to improve the restoration of social participation.5.The quality of life of burn patients at the medium to low level at the time of discharged from hospital and 1-month after discharged,at 3-month and 6-month discharged from hospital,the quality of life at medium level.Clinic members should pay more attention to status of quality of life related patients with inhalation injury and great itching,holding negative attitude of rehabilitation,and formulating targeted health management program by improving rehabilitation confidence and acceptance of disability,prompting activity participation in social life to improve comprehensive health of burn patients. |
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