Evaluation Of The Health-Related Quality Of Life During The Treatment Severe Burn Complicated By Multiple Organ Dysfunction Syndrome (Mods)

ACTA NEUROPSYCHOLOGICA(2014)

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摘要
Aim of the study: The aim of the research was an evaluation of the quality of life for an elderly patient treated for third-degree burn with the complication of multiple organ dysfunction syndrome (MODS).Case study: The patient, aged 79, was admitted to the Malopolska Center for Burns and Plastic Surgery at the Ludwik Rydygier Memorial Specialist Hospital, Krakow a week after burn. On admittance the presence of inveterate third-degree burns to the head, neck, right arm and lower limbs, which covered over 30% of the total body surface area, was diagnosed. The necrosis was removed; the wounds were closed by skin graft. The patient was treated according to a comprehensive rehabilitation programme. Tests into quality of life involved a clinical interview and measurement on the SF-36 scale. It was ascertained during the first test, one taken immediately on admittance to the burns unit, that the patient experienced a poor quality of life, something, which resulted chiefly from the lack of a sense of security and the previous hospital stay in a unit affording no professional medical care. In the second test, one taken 7 days after treatment at the MCOP, and after the third, following 14 days of treatment, the patient evaluated his quality of life as good. The improvement in the quality of life was connected to the absence of physical and psychic symptoms as well as being a result of the sense of security now felt derived from the professional help received. It was known from the interview that as soon as the first symptoms of multiple organ dysfunction syndrome (MODS) appeared the sense of quality of life started to deteriorate rapidly. At the moment when such a sensation became severe the patient was intubated with consciousness being pharmacologically switched off. At the same time as work was carried out on the correct healing of the burn wounds intensive effort was put into improving the patient's general state of being and the multidisciplinary treatment of the patient was conducted. However, after 24 days from the date of the burns MODS developed and the patient died in the symptoms of circulatory and respiratory insufficiency.Conclusions: An analysis of the test results obtained on the SF-36 scale allows one to state that the severely burned patient's quality of life was connected with the general state of his health both the physical and psychological as well as with the medical care offered. A deterioration in health along with a sense of poor life quality resulted from the patient being left without professional medical care at a previous medical unit, while an improvement in the evaluation of quality of life was obtained thanks to the specialist help he received enabling for a reduction of consequences of the burn.
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关键词
comprehensive rehabilitation, sensomotor reintegration, PTSD, depression
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