RESUMO
Burn injuries in low-resource settings like Nepal present significant public health challenges, leading to substantial morbidity, mortality and severe pain. This paper assesses burn pain management in Nepal, emphasizing the need for enhanced strategies. A case study of a female patient with severe burn injuries from a rural village in Western Nepal illustrates current challenges. Reviewing studies on burn pain management in Nepal shows limited access to specialized facilities, inadequate palliative care, medication shortages and insufficient healthcare professionals. Pharmacological interventions are impacted by financial constraints and a lack of protocols, while nonpharmacological approaches have not been explored and contextualized for the Nepalese context due to similar financial issues. Comprehensive burn pain management requires addressing resource constraints through collaborative health-aid partnerships.
Burn injuries are among the most painful conditions. Burn injury treatment poses a significant challenge to low-resource countries like Nepal. This review focuses on the case of a 35-year-old woman from rural Nepal who suffered severe burns from boiling water. It depicts the journey and ordeal of the patient to receive burn pain treatment in Kathmandu, Nepal.Effective management of burn pain requires a multidisciplinary approach, including pharmacological and nonmedical treatments such as wound care and psychological support. However, in Nepal, these treatments are often limited due to resource shortages and a lack of specialized medical centers. The patient was eventually transferred to a burn injury treatment center in Kathmandu, Nepal, where multiple surgeries, including skin grafts donated by family members, helped her survive.The review also discusses various aspects of burn injuries in Nepal and the challenges of burn injury treatment and burn pain management in Nepal. It highlights the necessity for establishing specialized burn injury treatment centers and implementing a comprehensive burn injury management plan. These measures aim to enhance outcomes and alleviate suffering for burn patients in Nepal and other low-resource settings.
RESUMO
Nepal is one of the developing countries having many limitations in providing the quality health services to its population. In many countries, improvement in patients' adherence to the pharmacotherapy had been one of major outcome of quality pharmaceutical services. Till date, very less thing has been done in this area in Nepal; so it seems mandatory to improve the patient adherence to the treatment plans. Adherence to the medical therapy can be explained by the extent of the behavioral coincidence to the medication and non-medication regimen by a patient whereas compliance and concordance are two different models of patient adherence to the therapy. Compliance model suggests that patients have been brought responsible for being unable to follow 'doctor's order and concordance tempts to measure the degree of agreement between patient and his or her clinician about the nature of illness and the best possible therapy for the welfare of the patient. Non-adherence to the therapy may lead to different problems as consequences of non-adherence in four different level- individual, institutional, societal and national levels. Although some programs like, "Direct Observation Treatment, Short-course (DOTS) for tuberculosis, implementation of antiretroviral treatment schedules for HIV patients and pediatric vaccination models," are the examples of attention towards the cases of noncompliance in Nepal. It has long been faced its limitations in the forms of either untrained manpower or lack of good documentation of patients' adherence to therapy or high illiteracy rate or unaffordibility of patients to their treatment or lack of pharmaceutical care services.