Community-based interventions for the prevention of burns and scalds in children

 

Abstract

Background

Burns and scalds are a significant cause of morbidity and mortality in children. Successful counter-measures to prevent burn and scald-related injury have been identified. However, evidence indicating the successful roll-out of these counter-measures into the wider community is lacking. Community-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to burn and scald injury in children.

Objectives

To assess the effects of community-based interventions, defined as coordinated, multi-strategy initiatives, for reducing burns and scalds in children aged 14 years and under.

Search methods

We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, National Research Register and the Web of Knowledge. We also handsearched selected journals and checked the reference lists of selected publications. The searches were last updated in May 2007.

Selection criteria

Included studies were those that reported changes in medically attended burn and scald-related injury rates in a paediatric population (aged 14 years and under), following the implementation of a controlled community-based intervention.

Data collection and analysis

Two authors independently assess studies for eligibility and extracted data. Due to heterogeneity between the included studies, a pooled analysis was not appropriate.

Main results

Of 39 identified studies, four met the criteria for inclusion. Two of the included studies reported a significant decrease in paediatric burn and scald injury in the intervention compared with the control communities. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities.

Authors' conclusions

There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children.

It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.

 

Plain language summary

Insufficient evidence so far to support the community approach to burns and scalds prevention

Multi-strategy, community-based interventions are widely promoted for reducing injury rates. The efficacy of this approach is difficult to assess and there have been few research studies of good quality. The current review sought to review studies evaluating the success of community-based programmes specifically intended to reduce burn and scald injury in children. Only four studies were identified that met the inclusion criteria and two of these found a reduction in rates of burns and scalding. More high-quality research studies are needed in this area, therefore, to support the continued use of the community approach.

 

摘要

背景

預防兒童燒燙傷之以社區為基礎的介入措施

燒燙傷是兒童罹病率及死亡率的重要原因。目前已有確定用來預防因燒燙傷受傷的對策。然而，缺少證據指出這些對策被成功的推行到更廣泛的社區。合併多種策略，多項目標計畫之以社區為基礎的介入措施被假設可以減少民眾的受傷率。這篇回顧檢驗這項假設對於兒童燒燙傷的效果。

目標

評估以社區為基礎之介入措施用以減少14歲以下兒童燒燙傷的效果，其定義為整合的，多種策略的措施。

搜尋策略

我們檢索the Cochrane Injuries Group's specialised register，CENTRAL，MEDLINE，EMBASE，CINAHL，PsycINFO，National Research Register及the Web of Knowledge。我們也以人工檢索特定的期刊，並檢閱特定之已發表文章的參考文獻。檢索的最後一次更新是在2007年5月。

選擇標準

納入那些報告兒童族群(14歲以下)中因燒燙傷而受傷之就醫改變量的研究，並有以社區為基礎的對照介入措施。

資料收集與分析

兩名作者分別評估研究的合格性並摘錄資料。由於所納入的研究間其異質性，因此無法進行適當的加總資料分析。

主要結論

確定39篇研究，其中4篇符合納入標準。納入的研究中有2篇研究報告，相較於對照社區，介入措施可以顯著地減少兒童燒燙傷的傷害。其他兩篇研究則沒有顯示正向的結果，這也許是因為介入措施的實施時間受到限制且/或社區不適當的執行對策的關係

作者結論

關於用來預防兒童燒燙傷之以社區為基礎的傷害預防計畫的效果，只有數量有限的研究可以做結論。目前迫切需要評估高品質之以社區為基礎的介入措施計畫，其根據有效的對策來減少兒童燒燙傷的發生。重要的是從預防的觀點考量兒童燒燙傷的問題以闡明架構，及實證的介入措施結合創新的計畫指引以適用於世界各地的社區來執行。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

目前沒有足夠的證據支持以社區的方法來預防燒燙傷。多種策略，以社區為基礎的介入措施被廣泛地提倡用來減少受傷率。這種方法的效益不易評估且很少有品質優良的研究。本篇回顧的目的是回顧研究，其評估成功用來減少兒童燒燙傷之以社區為基礎的計畫。只有確定4篇研究符合納入標準，且其中兩篇發現可以減少燒燙傷的比率。因此，這領域需要更多高品質的研究以支持社區方法的使用。