This study aims to evaluate a new self-management support intervention for burn survivors
called BreeZe. The overall goal of BreeZe is to enhance burn survivors' self-management
skills in order to integrate treatment and life goals and subsequently optimize burn
survivors' quality of life and health-related outcomes. The BreeZe intervention is based
on the content of the ZENN intervention, an evidence-based self-management support
intervention for transplant recipient patients, which we adapted to the context of burn
care. The BreeZe intervention is based on the theoretical framework of the
Self-Regulation Theory. The main intervention strategies are based on evidence-based
techniques, namely goal setting and pursuit, Solution-Focused Brief-Therapy, and
Motivational Interviewing. In practice, this means that the intervention focuses on a
positive approach in order to enhance burn survivors' intrinsic motivation and
self-efficacy to encourage sustainable behaviour change regarding self-management in
burns aftercare. To achieve this, we will implement BreeZe using various implementation
strategies. These will include educating healthcare professionals on self-management,
training them in communication skills (e.g. motivational interviewing), and providing
supportive materials such as a decision aid tool (i.e., self-management web) and a
workbook tailored for burn survivors.
This multicenter stepped-wedge hybrid type 2 effectiveness-implementation study aims to
evaluate BreeZe's effectiveness, and to evaluate the effects of our implementation
approach. The study includes a pre-implementation phase (usual care), implementation
phase, and a post-implementation phase (with BreeZe), and involves the three designated
burn centers in the Netherlands. The phases will be rolled out sequentially from April
2024 to November 2024, and enrollment of participants concludes in July 2025.
For evaluation, this study uses the RE-AIM evaluation framework, focusing on Reach,
Effectiveness, Adoption, Implementation, and Maintenance. Our co-primary outcomes are 1)
BreeZe's effectiveness in improving self-management skills in burn survivors, and 2) the
effects of our implementation approach on the implementation outcomes Reach, Adoption,
Implementation and Maintenance. Secondary effectiveness outcomes are self-regulation,
participation, dependency, and patient-centeredness for burn survivors, and
self-management support skills for healthcare professionals. Data collection for burn
survivors occurs at 2 weeks, 6 months, and 12 months post-discharge, using
questionnaires. Data collection for healthcare professionals occurs pre-implementation,
and 3, 6 and 12 months after implementation, using questionnaires, interviews, and video
observations.