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. 2025 Dec 26.
doi: 10.1186/s12913-025-13849-5. Online ahead of print.

Development of BreeZe: a self-management support intervention for burn survivors informed by evidence, theory, and stakeholder co-creation

Sven J G Geelen  1   2 , Sharon L Blok  1   2   3 , Anuschka S Niemeijer  1 , Gerbrig Bijker  1 , Irma Visser  4 , Rolf Bron  4 , Corry K van der Sluis  3 , Emma K Massey  5 , Denise van Uden  6 , Robin A F Verwilligen  7   8   9 , Anita Boekelaar-van den Berge  7 , Cornelis H van der Vlies  6   10   11 , Eelke Bosma  1   12 , Sonja M H J Scholten-Jaegers  1 , Marianne K Nieuwenhuis  13   14   15 ; National Burn Care, Education & Research group, the Netherlands
Collaborators, Affiliations
Free article

Development of BreeZe: a self-management support intervention for burn survivors informed by evidence, theory, and stakeholder co-creation

Sven J G Geelen et al. BMC Health Serv Res. .
Free article

Abstract

Background: Following a severe burn injury, individuals embark on a lifelong process of managing and integrating the physical, psychological, and social consequences, including functional limitations, fatigue, altered body image, and psychological trauma. To aid in this process, healthcare professionals can provide self-management support. To date, however, no self-management support intervention has been developed to meet the unique needs and preferences of burn survivors within the context of burn aftercare. In this article, we describe the process of developing a self-management support intervention for burn aftercare and present the resulting intervention.

Methods: A structured, multi-stage process was followed from May 2021 to December 2023 to develop the intervention, guided by established frameworks for the development and adaptation of complex interventions. The process included evidence review, stakeholder consultation, and participatory observations to identify needs, inform design decisions, and ensure contextual fit. A hybrid approach to intervention development was adopted, combining adaptation of an existing intervention with augmentation through five co-creative workshops involving burn survivors, healthcare professionals, researchers, and burn care decision-makers. The final prototype was refined through expert reviews and real-world pilot-testing to assess its feasibility and acceptability.

Results: The structured, multistage process resulted in a self-management support intervention addressing the physical, psychological, and social needs of burn survivors. The intervention was named BreeZe (Brandwonden en Zelfmanagement/Burns and self-management). Intervention Core components of the intervention include a holistic care approach, goal setting and action planning, solution-focused brief therapy, motivational interviewing, case management, and the acknowledgment and involvement of informal caregivers. BreeZe is supported by materials like the Self-Management Web, a patient booklet, training for healthcare professonials, and a comprehensive manual. BreeZe is delivered by trained healthcare professionals and is structured into five phases, focusing on holistic needs assessment, goal setting, progress monitoring, and ongoing motivational support.

Conclusions: The structured, multi-stage development process was thorough and carefully considered, balancing diverse stakeholder perspectives with scientific evidence and theory. BreeZe offers an evidence-based model tailored to the Dutch context that can be integrated into routine practice that shows the potential to enhance the effectiveness of care and support a more collaborative, patient-centred approach.

Trial registration: Not applicable.

Keywords: Burns; Case management; Complex intervention; Goal setting; Holistic care; Intervention adaptation; Intervention development; Motivation; Post-acute care; Rehabilitation; Self-determination; Self-efficacy; Transmural care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All study procedures were conducted in accordance with relevant guidelines and regulations including the Declaration of Helsinki. Ethical approval was obtained where required (e.g., interview studies), with approval granted by the Ethics Committee of the Martini Hospital [2022–092; 2022–093; 2023–008] and re-approved locally at the Maasstad Hospital and Red Cross Hospital. Participants involved in relevant stages of the study provided written informed consent prior to participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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