Quality of life of burn survivors treated in the military burn center.

BACKGROUND: Limited research explains the quality of life (QOL) among burn survivors during post-hospitalization rehabilitation. PURPOSE: To determine the QOL of military and civilian burn survivors treated in the military burn center. METHODS: In this longitudinal study, QOL was examined in 131 burn survivors (88 civilians; 43 military). Participants completed the Abbreviated Burn Specific Health Scale (BSHS-A) and the Satisfaction with Life Scale (SWLS) over 5 time points post-discharge. DISCUSSION: Civilian and military participants reported improved QOL over time on most BSHS-A subscales. Military participants had higher global BSHS-A scores at discharge, but at 6 months plateaued while civilians improved and had higher global BSHS-A scores at 18 months. Scores on the SWLS were consistently higher for military participants than for civilians. CONCLUSION: Military versus civilian patients may have different expectations about their ability to rehabilitate. The post-hospitalization period needs to be better understood to develop appropriate QOL interventions.

CE: Original Research: Staff nurses' use of research to facilitate evidence-based practice.

OBJECTIVES: To determine to what extent RNs in an acute care multihospital system used research findings in their practice; what types of knowledge they used in their practice; and what personal, professional, and organizational factors enhanced or hindered their research utilization. METHODS: A cross-sectional, descriptive, online survey design was used. The survey, which asked about use of research findings in practice and evidence-based practice (EBP) participation, was placed on the hospital system intranet. Of the 2,900 RNs invited to participate, 1,112 nurses completed usable surveys, for a response rate of 38%. This article reports findings for 794 of the staff nurses who responded to the survey. RESULTS: The forms of knowledge that staff nurses reported relying on most were their personal experience with patients, conferences, hospital policies and procedures, physician colleagues, and nursing peers. Although a variety of resources were available for nurses to use in locating research and implementing EBP, respondents reported many of the same barriers that have been reported in other studies over the last two decades: lack of time, lack of resources, and lack of knowledge. Although their attitudes about research utilization and EBP were positive overall, respondents expected unit-based educators and clinical nurse specialists to collect and synthesize the research for them. CONCLUSIONS: These findings are similar to those of other recent studies regarding nurses' research utilization and EBP. A great deal of work remains to be done if we are to inform, educate, and assist staff nurses in using research and implementing EBP. It may be unrealistic to expect bedside nurses to add these activities to their duties unless they are compensated for the time and have the support of master's or doctorally prepared nurses to serve as EBP coaches and champions.

Use of the videophone to collect quality of life data from burn patients.

Collecting quality of life (QOL) data longitudinally from burn survivors is difficult; especially if they live in geographically distant areas from the burn center. Although mailed surveys can be used, response rates to these surveys may be low. The purpose of this feasibility study was to examine the use of the videophone to collect QOL data from burn patients over 5 time points after discharge from the U.S. Army Institute of Surgical Research Burn Center. Twenty-five patients agreed to participate, using the Starview 2000 Pro II videophone. Participant satisfaction with the technology was measured using the Telemedicine Perception Questionnaire. Qualitative comments from participants and the researchers conducting the videophone data collection sessions also were collected. Military participants were approximately 20 years younger than civilian participants. Most burns were from a thermal cause and civilian patients had a slightly shorter length of stay in the burn center than military participants. The majority of participants were relatively happy with the telehealth technology, rating it with a mean score of 61.84 out of a possible total score of 85. Qualitative comments also reflected a positive attitude about the use of the videophone for research data collection; 60% of the participants said they remained in the study because they were allowed to use the videophone rather than using only the telephone or a mailed survey. The researchers collecting the data also commented about the ease of using the videophone. Negative comments were related to dropped calls or lack of audio or video at certain times. Findings from this study are consistent with the two other studies that reported use of telemedicine to clinically evaluate burn patients. With the rapid advancement of technology, QOL research data could be collected longitudinally from burn patients by using laptops with high resolution, portable video cameras.

Critical access health care: a concept analysis.

PURPOSE: The purpose of this paper is to provide a concept analysis of critical access health care. A common understanding of critical access health care would benefit those who legislate, provide, and consume health care. METHODS: A review of the literature was conducted using an identical set of search terms that yielded a variety of sources; however, none were specifically related to critical access health care. FINDINGS: No literature of concept analysis of critical access health care could be found. CONCLUSIONS: A concrete and measurable understanding of the concept will provide a common foundation to assist public and private entities in developing viable methods to understand healthcare policies, problems related to access, disparities in health care, and ways to increase health promotion and disease prevention.