The Bridge: A Mobile Application for Burn Patients

BACKGROUND: The Bridge Mobile Application (App) for Burn Patients is the first mobile app of its kind and is tailored specifically toward the recuperative needs of patients in the first 90 days after discharge from a regional burn center.  Global use of the internet has become commonplace, and smart phones have paved the way for technological mobility. The primary goal for the Bridge App is to decrease unplanned hospital re-admissions, followed by increased quality of life and resilience in short-term recovery. 

METHODS: App content was developed using qualitative data obtained from three focus groups in an effort to explore and elucidate stakeholders’ understandings of bio-psycho-social education and messages that they believed would improve short-term outcomes for newly discharged burn patients. Focus group #1 consisted of five burn nurses; focus group #2 consisted of two attending Plastic Surgeons and six Plastic Surgery residents; focus group #3 consisted of eight, adult burn survivors from the burn center’s support group. Focus groups were asked the same five questions and time-span for group sessions ranged between 60-90 minutes.  Audio recordings were transcribed verbatim and narratives were analyzed for themes important to burn recovery.  The interviewer documented contextual data reflecting group social processes. Practice theory was utilized to guide data analysis, recognizing the inter-connectedness between bodily movement, mental activities, and background knowledge that took the form of understanding, emotional states and motivational knowledge.

FINDINGS:  Content analysis of data identified frequent problems and potential features that distance support would benefit burn recovery. Identified themes included positive cognitive-behavioral messaging to support adaptation to burn disfigurement and individual resilience, educational messaging about nuances of burn wound care, infection and healing, instructional videos representing hand hygiene, wound care and dressing changes, and videos depicting full body range of motion exercises to reduce scar contractures.  Links to hotlines and other burn-supportive web sites were added.  

CONCLUSION & IMPLICATIONS: The Bridge app will provide accessible support 24 hours a day, seven days a week through recovery-stage appropriate bio-psycho-social content, delivered directly to user’s smart phones. The “back-end” of the app details quantitative user input reflecting pain, anxiety, mood and itching and graphs scores so that users can review their progress.  Each time users log into the app, the content viewed will be dated and time stamped, providing a scrubbed data bank for future research. In addition, data on medication compliance, social participation, self-efficacy and return to work are all collected on a password protected, HIPPA compliant, encrypted mainframe. Surveys will be delivered at the end of the 90-day Bridge delivery system to maximize data input regarding short-term burn user recovery and app use.  Surveys will include the Burn-Specific Health Scale-Brief (BSHS-B), Conner-Davidson Resilience Scale-25 (CD-RISC-25), CAGE-AID, Gratitude Questionnaire-6 (GQ-6) and App User Satisfaction survey.  Incorporation of smart phone technology has the potential to positively affect recovery outcomes for those with major burn injuries through use of a health-directed application (apps), particularly for those patients living in rural and other medically under-served areas.