The Role of Palliative Care in Burns: A Scoping Review

Jonathan Bayuo; Katherine Bristowe; Richard Harding; Frank Bediako Agyei; Anita Eseenam Agbeko; Pius Agbenorku; Prince Kyei Baffour; Gabriel Allotey; Paa Ekow Hoyte-Williams

doi:10.1016/j.jpainsymman.2019.11.006

The Role of Palliative Care in Burns: A Scoping Review

Jonathan Bayuo^*, Katherine Bristowe, Richard Harding, Frank Bediako Agyei, Anita Eseenam Agbeko, Pius Agbenorku, Prince Kyei Baffour, Gabriel Allotey, Paa Ekow Hoyte-Williams

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

28 Citations (Scopus)

Abstract

Context: Patients with severe burns may face distressing symptoms with a high risk of mortality as a result of their injury. The role of palliative care in burns management remains unclear. Objective: To appraise the literature on the role of palliative care in burns management. Methods: We used scoping review with searches in 12 databases from their inception to August 2019. The citation retrieval and retention are reported in a PRISMA statement. Findings: 39 papers comprising of 30 primary studies (26 from high-income and four from middle-income countries), four reviews, two editorials, two guidelines, and one expert board review document were retained in the review. Palliative care is used synonymously with comfort and end-of-life care in burns literature. Comfort care is mostly initiated when active treatment is withheld (early deaths) or withdrawn (late deaths), limiting its overall benefits to burn patients, their families, and health care professionals. Futility decisions are usually complex and challenging, particularly for patients in the late death category, and it is unclear if these decisions result in timely commencement of comfort care measures. Three comfort care pathways were identified, but it remained unclear how these pathways evaluated “good death” or supported the family which creates the need for the development of other evidence-based guidelines. Conclusion: Palliative care is applicable in burns management, but its current role is mostly confined to the end-of-life period, suggesting that it is not been fully integrated in the management process. Evidence-based guidelines are needed to support the integration and delivery of palliative care in the burn patient population.

Original language	English
Journal	Journal of pain and symptom management
DOIs	https://doi.org/10.1016/j.jpainsymman.2019.11.006
Publication status	Published - 1 Jan 2019

Keywords

Burns
comfort care
end of life
evidenced-based guidelines
palliative care

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10.1016/j.jpainsymman.2019.11.006

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title = "The Role of Palliative Care in Burns: A Scoping Review",

abstract = "Context: Patients with severe burns may face distressing symptoms with a high risk of mortality as a result of their injury. The role of palliative care in burns management remains unclear. Objective: To appraise the literature on the role of palliative care in burns management. Methods: We used scoping review with searches in 12 databases from their inception to August 2019. The citation retrieval and retention are reported in a PRISMA statement. Findings: 39 papers comprising of 30 primary studies (26 from high-income and four from middle-income countries), four reviews, two editorials, two guidelines, and one expert board review document were retained in the review. Palliative care is used synonymously with comfort and end-of-life care in burns literature. Comfort care is mostly initiated when active treatment is withheld (early deaths) or withdrawn (late deaths), limiting its overall benefits to burn patients, their families, and health care professionals. Futility decisions are usually complex and challenging, particularly for patients in the late death category, and it is unclear if these decisions result in timely commencement of comfort care measures. Three comfort care pathways were identified, but it remained unclear how these pathways evaluated “good death” or supported the family which creates the need for the development of other evidence-based guidelines. Conclusion: Palliative care is applicable in burns management, but its current role is mostly confined to the end-of-life period, suggesting that it is not been fully integrated in the management process. Evidence-based guidelines are needed to support the integration and delivery of palliative care in the burn patient population.",

keywords = "Burns, comfort care, end of life, evidenced-based guidelines, palliative care",

author = "Jonathan Bayuo and Katherine Bristowe and Richard Harding and Agyei, {Frank Bediako} and Agbeko, {Anita Eseenam} and Pius Agbenorku and Baffour, {Prince Kyei} and Gabriel Allotey and Hoyte-Williams, {Paa Ekow}",

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doi = "10.1016/j.jpainsymman.2019.11.006",

language = "English",

journal = "Journal of pain and symptom management",

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T1 - The Role of Palliative Care in Burns

T2 - A Scoping Review

AU - Bayuo, Jonathan

AU - Bristowe, Katherine

AU - Harding, Richard

AU - Agyei, Frank Bediako

AU - Agbeko, Anita Eseenam

AU - Agbenorku, Pius

AU - Baffour, Prince Kyei

AU - Allotey, Gabriel

AU - Hoyte-Williams, Paa Ekow

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Context: Patients with severe burns may face distressing symptoms with a high risk of mortality as a result of their injury. The role of palliative care in burns management remains unclear. Objective: To appraise the literature on the role of palliative care in burns management. Methods: We used scoping review with searches in 12 databases from their inception to August 2019. The citation retrieval and retention are reported in a PRISMA statement. Findings: 39 papers comprising of 30 primary studies (26 from high-income and four from middle-income countries), four reviews, two editorials, two guidelines, and one expert board review document were retained in the review. Palliative care is used synonymously with comfort and end-of-life care in burns literature. Comfort care is mostly initiated when active treatment is withheld (early deaths) or withdrawn (late deaths), limiting its overall benefits to burn patients, their families, and health care professionals. Futility decisions are usually complex and challenging, particularly for patients in the late death category, and it is unclear if these decisions result in timely commencement of comfort care measures. Three comfort care pathways were identified, but it remained unclear how these pathways evaluated “good death” or supported the family which creates the need for the development of other evidence-based guidelines. Conclusion: Palliative care is applicable in burns management, but its current role is mostly confined to the end-of-life period, suggesting that it is not been fully integrated in the management process. Evidence-based guidelines are needed to support the integration and delivery of palliative care in the burn patient population.

AB - Context: Patients with severe burns may face distressing symptoms with a high risk of mortality as a result of their injury. The role of palliative care in burns management remains unclear. Objective: To appraise the literature on the role of palliative care in burns management. Methods: We used scoping review with searches in 12 databases from their inception to August 2019. The citation retrieval and retention are reported in a PRISMA statement. Findings: 39 papers comprising of 30 primary studies (26 from high-income and four from middle-income countries), four reviews, two editorials, two guidelines, and one expert board review document were retained in the review. Palliative care is used synonymously with comfort and end-of-life care in burns literature. Comfort care is mostly initiated when active treatment is withheld (early deaths) or withdrawn (late deaths), limiting its overall benefits to burn patients, their families, and health care professionals. Futility decisions are usually complex and challenging, particularly for patients in the late death category, and it is unclear if these decisions result in timely commencement of comfort care measures. Three comfort care pathways were identified, but it remained unclear how these pathways evaluated “good death” or supported the family which creates the need for the development of other evidence-based guidelines. Conclusion: Palliative care is applicable in burns management, but its current role is mostly confined to the end-of-life period, suggesting that it is not been fully integrated in the management process. Evidence-based guidelines are needed to support the integration and delivery of palliative care in the burn patient population.

KW - Burns

KW - comfort care

KW - end of life

KW - evidenced-based guidelines

KW - palliative care

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DO - 10.1016/j.jpainsymman.2019.11.006

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AN - SCOPUS:85076523312

SN - 0885-3924

JO - Journal of pain and symptom management

JF - Journal of pain and symptom management

ER -

The Role of Palliative Care in Burns: A Scoping Review

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