The individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns (WHO, 1997)
others
Description
OPERATIONAL DEFINITIONS
Quality of life: The individual’s perception of their position
in life in the context of the culture and value systems in which they live and
in relation to their goals, expectations, standards and concerns (WHO, 1997)
Upper
limbs burn: is an injury that affects the region extending
from the deltoid region up to the hand and including the arm, axilla and
shoulder and primarily caused by heat or due to radiation,
radioactivity, electricity, friction or contact with chemicals
Social relations: a social relation or social interaction is any relationship between two or more individuals
Poor quality of life: lack of fulfillment of basic needs as well as social physical needs.
ABSTRACT
Introduction: upper limbs burns can result in number of
devastating functional impairment and social consequences that can hamper
quality of life. Burns are among the leading causes of disability adjusted
years of life (DALYs) in LMICs and
majority of burn patients had burns that involved upper limbs. Upper limbs
burn has long lasting impact on the quality of
people’s lives with persisting problems related to scarring, contractures and
weakness these will lead to limitation of range of movements and social
wellbeing.
General
objective: To determine the quality of life among
patients with burns of the upper limbs at KNRH.
Methods:
This was
a cross-sectional study recruited 107 participants of 5 years and above who
have been discharged between June 2019 to December 2019 from Kiruddu National
Referral Hospital with burns of upper limbs. Recruitment was consecutive from burns
unit clinic following ethical
approval from School of Medicine Research and ethics Committee (SOMREC). Participants
were given a burn related QOL questionnaire. Data was then entered into Epidata
4.2 and imported into STATA 15.1 for analysis. Factors associated with poor
quality of life were determined by modified Poisson regression to generate
prevalence ratios with their 95% confidence intervals.
Results: A total of 108 participants were
recruited for the study, 97 (89.8%) were adults and responded to the adult QOL questionnaire
while the rest were pediatrics. The mean age of the adults was 28 years
(SD=8.6) while the median age of the pediatrics was 8 years (IQR =6-10) and
61.1% were male. The upper extremity function (physical) quality of
life was good while the social aspect quality of life was poor. The factors
associated with poor quality of life were degree(deep) of burns, number of surgeries, age above 55 years and being
divorced.
Conclusions and recommendations:
There is
generally poor upper extremity function or physical QOL among both adults and
children while there is generally good social aspects QOL among adults and
children
Recommendations
We recommend a multidisciplinary
team approach while managing patient with upper limbs burns. We recommend scaling
up clinic days for follow up visits for patients with burn injuries to assess
their upper extremity function and social aspects quality of life and establish
management appropriately.
CHAPTER ONE
Introduction and background
A burn is an injury to the skin or other
organic tissue primarily caused by heat or due to radiation, radioactivity,
electricity, friction or contact with chemicals(“WHO | Burns,” n.d.).
Upper limbs have
major role in the body movements it
carries out many functions such as
prehension, manipulation and wide range of movement which play an important
role for successful integration into the society and professional life(Kitzinger et al.,
2012).
Therefore they need adequate management for enable physical functioning(Harvey et al.,
1996; Luce, 2000).
Literature
reported that upper limbs burns patients had poor quality of life due to scarring,
contractures, weakness, thermoregulation, itching, pain, body image and
psychosocial wellbeing(Moi et al., 2016). Burns are one
of the most common causes of disability in LMICs WHO, 2018. In Mulago National
referral hospital burn injuries represents16.7% of total injuries (Renee Y.
hsia, 2010). In kawempe division, Uganda burns were the leading
cause of severe injuries in children or younger 41% .(Kobusingye et
al., 2001).
Upper limbs
injuries had an incidence of 1130 per 100,000 per year in United States, injuries
to the fingers account for 38.4% and upper limbs injuries due to burn account
for1.6%(Ootes et al.,
2012).
Study showed
that age, sex, low social economic status, low education levels, and occupation are associated with poor
quality of life (Shahid et al.,
2017).
Burns of upper limbs affected significantly the activities of daily living by
limiting the movements of the upper limbs joints (Nanayakkarawasam
P P et al., 2015).
After hospital
discharge, most patients of upper limbs burn showed abnormal behaviors such as
preferring to be lonely due to scars and bodily changes caused by the burn especially
in the first year (Ciofi-Silva et
al., 2010).
