Health related quality of life after burns: are we really treating burns?

Background: During the last few decades management of burns has undergone positive revolutionary change. Today, over 50% of all patients with burns involving 80% of their total body-surface area can survive. Although the objective assessment by attending physician can well define a patient's degree of health, the patient's subjective perceptions and expectations that can influence burn survivors' experience of their life is much more important. Methods: Adult burn patients of both sexes admitted to burn unit with major burns either by size or site who required reconstruction for burn injury were the subjects of this study. The health related quality of life was assessed using SF-36v2[R], questionnaire. Results: The mild to moderate pain complaint by 87 [88%] of all burn survivors, badly impact role physical and general health with resultant decrease in physical component summary. What was more difficult to explain was the decreased mental health which is evident soon after the incidence and persisted throughout the period of follow-up, showing statistically insignificant improvement whe compared from basal score [p=0.008]. Longitudinal decline in HRQoL had strong relationship with female sex, involvement of prime area, hospital admissions, hospital stay and sessions of surgery. Sex, occupation, involvement of prime area and hospital admissions, were the important predictors for decrease in physical component summary of burn survivors. Involvement of prime area and hospital admissions were important determinant for decrease in mental component summary. Conclusion: The level and quality of multidisciplinary rehabilitation that these victims needs is very low as compared to developed countries. These patients need long term professional, psychological, and social support. Keywords: Quality of Life, Burn Survivors, Health related Quality of Life, subjective health

Lessons learned from health and fitness prescription: a Malaysian experience.

Proportion of chronic diseases sufferers are increased by age. The usual control measures are therapeutic prescription and clinical counseling. However, its low compliance rate has interfered this effort. Therefore, community intervention can be a suitable prescriptive option to provide a long lasting effect. For that, a package of community intervention has been established in one sub-urban area in Malaysia to observe its acceptability, thus it can be acted as a social instrumentation to bring both biological and social benefits to this group of community. This study used quasi-experimental design on a cohort of elderly citizen aged 45 and above. Respondents are exposed to a mixed and planned prescribed fitness activity using participatory approach. Process involved in program implementation is closely observed both quantitatively and qualitatively. Community participation occurred in a positive and fast mode, with 78% being the elderly people aged above 45 years old. Initial observation revealed that about 47.6% suffering hypertension, while 38.4% hypercholesterolemia, 16.8% obese and 7.1% diabetes mellitus. Physically active members were moderate - about 31.0%. In term of process, participatory approach seems to be very effective to mobilize community towards health and fitness. A planned community fitness program is a form of social instrumentation to bring biological and social benefits to chronic diseases sufferers. It has also useful to promote favorable lifestyle and quality of life of this group of people.