Intervention Content and Outcomes of Post-discharge Rehabilitation Programmes for Adults Surviving Major Burns: A Systematic Scoping Review

Improvement in burn care has led to more patients surviving the injury but has also led to more burn survivors requiring rehabilitation for a protracted period after discharge. Thus, this review sought to map the intervention content and outcomes associated with existing post-discharge rehabilitation programmes for adults surviving major burns. A systematic scoping review approach was utilised. The Template for Intervention Description and Replication (TIDieR) and core outcome set for adult burn survivors were used to guide data extraction following which a narrative synthesis was undertaken. In all, 23 papers were retained in the review. Following discharge and up to 1year post-burn, the components of the rehabilitation programmes comprised of physical, psychological, and social components. Beyond 1year post-burn, the rehabilitation programmes demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programmes up to 1year post-burn covered the seven core outcome domains. Outcomes associated with rehabilitation programmes beyond 1year post-burn were however limited to the perceived quality of life, neuromuscular and physical role functioning domains. Although most studies reported statistically significant findings, the outcome measures varied across studies which makes it difficult to draw overarching conclusions. The findings suggest that long-term rehabilitation programmes for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programmes. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.