[Investigation of burn rehabilitation development of China in 2014]

Objective: To further study the development of burn rehabilitation in China, so as to promote the development of burn rehabilitation in China. Methods: The questionnaire about the development of burn rehabilitation treatment was started by Specialized Committee of Burn Treatment and Rehabilitation Science of Chinese Association of Rehabilitation Medicine (hereinafter referred to as Specialized Committee) in the end of 2014, and 65 affiliations of Specialized Committee members participated in. There was a total of 26 questions, mainly focusing on problems as below: (1) General information of the burn department of the units, including the number of authorized beds, annual admitted burn patients, annual admitted patients with extremely severe burn, doctors, nurses, rehabilitation therapists, and the condition of rehabilitation area and rehabilitation beds, etc. (2) Development of burn rehabilitation treatment, including the development of rehabilitation treatment, the intervention time of rehabilitation treatment, the rehabilitation treatment carried out in intensive care unit (ICU), the composition of rehabilitation treating personnel, and the professional title and background, educational background, and division of responsibilities of rehabilitation therapists, etc. (3) Major problems affecting the development of burn rehabilitation treatment of the units. The burn treatment units were grouped according to the number of annual admitted patients. The units' situation of authorized beds, admitted patients, allocation of medical personnel and rehabilitation, and the ratio of beds to doctors, beds to nurses, beds to full-time burn rehabilitation treating personnel were recorded. Data were processed with t test, one-way analysis of variance, and chi-square test. Results: (1) A total of 65 questionnaires were sent, and 45 questionnaires (69.2%) were retrieved. Among the 45 units that replied the questionnaires, 35 units were burn treatment units. (2) The 35 burn treatment units were divided into less than 500 cases group (n=8), 501-1 000 cases group (n=11), 1 001-1 500 cases group (n=10), and more than 1 500 cases group (n=6) according to the number of annual admitted patients. The number of authorized beds of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group (t=4.563, P<0.05). The number of authorized beds of units in more than 1 500 cases group was significantly more than that in the other 3 groups, respectively (with t values from 1.859 to 3.743, P values below 0.05). The number of annual admitted patients of units in 501-1 000 cases group, 1 001-1 500 cases group, and more than 1 500 cases group was dramatically more than that in less than 500 cases group (with t values from 6.027 to 12.684, P values below 0.05). The number of annual admitted patients of units in 1 001-1 500 cases group and more than 1 500 cases group was significantly more than that in 501-1 000 cases group (with t values respectively 7.408 and 6.980, P values below 0.05). The number of annual admitted patients of units in more than 1 500 cases group was significantly more than that in 1 001-1 500 cases group (t=4.239, P<0.05). The number of annual admitted patients with extremely severe burn and the condition of rehabilitation area and rehabilitation beds of units in the 4 groups was similar (F=0.820, with χ(2) values respectively 5.266 and 2.848, P values above 0.05). The number of doctors of units in more than 1 500 cases group was significantly more than that in less than 500 cases group (t=2.836, P<0.05). The number of nurses of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group (t=2.837, P<0.05). The number of nurses and that of rehabilitation therapists of units in more than 1 500 cases group were significantly more than those in the other 3 groups (with t values from 1.762 to 4.789, P values below 0.05). (3) The 35 burn treatment units were able to provide at least one rehabilitation treatment for patients, among which body positioning, motion of joint exercise, infrared ray irradiation, hydrotherapy, function training, activities of daily life training, scar massage, and drug injection in scar were carried out well, while psychological therapy, music therapy, occupational rehabilitation, and social rehabilitation were mostly not carried out. (4) Only 9 (25.7%) burn treatment units started rehabilitation treatment for patients within 3 days after injury. (5) Twenty-seven (77.1%) burn treatment units could carry out body positioning in ICU. (6) Twenty-three burn treatment units had full-time rehabilitation treating personnel, and the units were divided into less than 500 cases group (n=1), 501-1 000 cases group (n=8), 1 001-1 500 cases group (n=9), and more than 1 500 cases group (n=5) according to the number of annual admitted patients. The ratio of beds to doctors of units in more than 1 500 cases group was significantly higher than that in 501-1 000 cases group (t=2.810, P<0.05) and the ratios of beds to doctors of units in 501-1 000 cases group and 1 001-1 500 cases group were similar (t=1.506, P>0.05). The ratios of beds to nurses and beds to full-time burn rehabilitation treating personnel in 4 groups were similar (with F values respectively 0.783 and 0.434, P values above 0.05). (7) Twenty burn treatment units had rehabilitation therapists with rehabilitation treatment related professional background (a total of 73 person, account for 76.0%), 80.8% (59/73) rehabilitation therapists with rehabilitation and therapeutic professions, 60.3% (44/73) with bachelor degree or above, and 87.7% (64/73) with primary and intermediate titles. Besides, 39.7% (29/73) rehabilitation therapists did physical therapy; 12.3% (9/73) rehabilitation therapists did occupational therapy; 38.4% (28/73) rehabilitation therapists did not have specific duties. (8) During the development of burn rehabilitation treatment of 35 burn treatment units, the common problems were reflected in the authorized strength and professional technology level of rehabilitation treatment relating personnel, and the area and equipment for rehabilitation. There were also many problems in cooperation between burn surgeons and rehabilitation therapists and fund. The supports from hospital and department leaders were good. Conclusions: Through the development of several years, the general condition and the development of rehabilitation treatment of burn treatment units in China are improved; the beginning time of burn rehabilitation treatment is advanced; the number of rehabilitation treatment personnel is increased with their speciality improved; the burn rehabilitation work get great support from hospitals and departments.