Anusha Jayaram, MD MBA
Nominated From: University of Washington
Research Site: Nepal Cleft and Burn Center – Kirtipur Hospital
Research Area: Burn Surgery
Research Area: Dr. Barclay Stewart
Research Project
Implementation and evaluation of peer support groups for burn injury survivors
Introduction: Peer support programs for burn injury survivors have been demonstrated to improve many outcomes including social reintegration, comfort with burn care, increased stress management and coping tools, improved body image and self agency, and a reduction in PTSD and anxiety, however no such programs currently exist in Nepal. Methods: We will create and implement context-specific peer support groups for burn injury survivors at Nepal Cleft and Burn Center in Kirtipur Hospital. We will analyze outcomes of this implementation through analyzing changes in psychosocial and medical outcomes and also evaluate the implementation of the groups with implementation science. Results: We hypothesize that the context-specific implementation of peer support groups will be successful across eight different domains of analysis (acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, sustainability), in addition to improving medical and psychosocial outcomes for burn injury survivors. Conclusion: The successful implementation of peer support for burn injury survivors at Kirtipur hospital will be a model to implement in healthcare centers across Nepal and in other low-resources settings, and we believe will improve burn injury care across multiple domains for survivors and their caregivers.
Research Significance
Global burden of disease studies estimate 9 million burn injuries and 120,000 burn related deaths occur annually. Low- and middle-income countries see a disproportionate amount of this burden, experiencing an estimated 70% of burn injuries, with the poorest in these populations being even more disproportionately affected. Women globally, especially in LMICs, experience a higher proportion of burn injuries, especially as it relates to kitchen and cooking accidents and especially in areas of the world where such responsibilities are disproportionately held by women. Burn injuries in Nepal account for the 3rd most frequent mechanism of injury with approximately 2% of the population experiencing burn injuries annually, which is one of the highest incidences in the world. Women in Nepal experience a higher proportion of burn injuries, as do people aged 0-54. Injuries have been primarily noted to be flame injuries (66%) related to cooking and warming near open fires. Even at dedicated burn injury centers, mortality rates have been calculated at 19.4%. Peer support programs for burn injury survivors have been demonstrated to improve many psychosocial outcomes including improved social reintegration, comfort with burn care, increased stress management and coping tools, improved body image and self-agency, and a reduction in PTSD and anxiety. Currently there are no formal peer support programs in place for burn injury survivors in Nepal, and a deficit of data on the implementation of peer support programs for burn injury survivors in the global south.
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