The Rehabilitation/School Matrix: A Model for Accommodating the Noncompliant Child With Severe Burns

Factors associated with adherence to follow-up care after burn injuries

INTRODUCTION

In South Africa, burns result in excessive morbidity which can be mitigated via follow-up treatments. This study evaluated factors associated with care retention for after burn injuries.

METHODS

A retrospective chart review was performed for twelve months of care at the public burn facility in Kwazulu-Natal, South Africa. All inpatients were eligible, although those who were transferred or died during care were excluded. The primary outcome was return for initial appointment one-week after discharge. The population was analyzed descriptively, and multivariable logistic regression was employed to yield adjusted odds ratios (aOR) with associated 95% confidence intervals (CIs).

RESULTS

From 354 patients 310 were analyzed. Of these, 177 (57.47%) were children (<12 years). One third (33.12%) of patients were non-adherent to follow-up (n = 102). In multivariable analysis, children ≤12 years of age were more likely to follow up (aOR = 1.87; 95% CI: 1.07-3.25, p = 0.028), as were those who underwent an operation (aOR = 2.69; 95% CI: 1.47-4.91, p = 0.001). Residing ≥50 km from the health center was associated with lower likelihood of follow up (aOR = 0.52; 95% CI: 0.29-0.93, p = 0.027).

CONCLUSION

High follow up attrition suggests the need for enhanced engagement in the high-risk burn population studied, and the identified factors could be leveraged in such programming.

Effect of safety education on classmates of injured children: a prospective clinical trial

We hypothesized that using the teachable moment associated with an injured classmate, school-aged children would demonstrate improved retention of injury prevention education. The injured child's class and one control with presentation class received an injury prevention presentation. Prospective evaluation was performed using pre, immediate post, and 1-month posttesting. Immediately following the presentation, 83% of classes in both groups demonstrated significant improvement in test scores. At 1 month, 100% of the injured child's and only 66% of control with presentation classrooms maintained significant improvements. This unique program results not only in immediate but also in long-term retention of injury prevention information.