Burns were far more common among children although gender differences arose only among adults. Men sustained more injuries of somewhat different aetiology and were referred to higher levels of care more often for comparable wound severity. The results suggest different disposition between men and women despite similar AIS scores. However, further studies with more comprehensive information on severity level and other care- and patient-related factors are needed to explore these results further.
BackgroundThe referral process in acute care remains challenging in many areas including burn care. Mobile phone apps designed explicitly for medical referrals and consultations could streamline the referral process by using structured templates and integrating features specific to different specialties. However, as these apps are competing with commercial chat services, usability becomes a crucial factor for successful uptake.ObjectiveThe aim of this study was to assess the usability of a mobile phone app for remote consultations and referrals of burn injuries.MethodsA total of 24 emergency doctors and 4 burns consultants were recruited for the study. A mixed-methods approach was used including a usability questionnaire and a think-aloud interview. Think-aloud sessions were video-recorded, and content analysis was undertaken with predefined codes relating to the following 3 themes: ease of use, usefulness of content, and technology-induced errors.ResultsThe users perceived the app to be easy to use and useful, but some problems were identified. Issues relating to usability were associated with navigation, such as scrolling and zooming. Users also had problems in understanding the meaning of some icons and terminologies. Sometimes, some users felt limited by predefined options, and they wanted to be able to freely express their clinical findings.ConclusionsWe found that users faced problems mainly with navigation when the app did not work in the same way as the other apps that were frequently used. Our study also resonates with previous findings that when using standardized templates, the systems should also allow the user to express their clinical findings in their own words.
Introduction: The rapid adoption of smartphones, especially in low-and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.
BackgroundGender differences have been reported both in exposure to and outcome of burn injuries. Whereas the general gender distribution of burns is relatively well known, few studies have examined gender differences in incidence and management of burns for different burn mechanisms in sub-Saharan Africa.MethodsThe study is cross sectional and based on case reports of patients seeking care for a burn injury at Emergency Centres in eight health care facilities in the Western Cape Province, South Africa between June 2012 and May 2013 (n = 1915). Gender specific incidence rates were compiled for age groups 0–4, 5–9, 10–14, 15–19, 20–54 and 55+. Differences in proportions in men and women were examined for AIS, length of stay and disposition. All analyses were stratified by burn mechanism.ResultsChildren 0–4 years have the highest incidence of burns with boys and girls relatively equally affected. Gender differences in burn incidence are found in ages 20 years and older. Men 55 years and older have a higher risk compared to women for hot liquid burns whereas men aged 20–54 have a higher risk of fire burns. While no gender differences in children are observed in injury management, adult men are significantly more transferred than women (all burn mechanisms aggregated) while women with both hot liquid and fire burns are treated as outpatients to a higher extent. No gender difference in AIS or length of stay are found among adults.ConclusionsEven though burn incidence is highest among children, gender differences in burn incidence and management are mainly visible in adults. Results about men being transferred and women treated as outpatients to a higher extent in spite of similar AIS raise the question of hidden gender biases in the healthcare.
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