Hand function is an important part of participation in occupations across the domains of self-care, productivity, and leisure. Interruption to hand function can be caused by injuries or conditions which limit how an individual is able to use and engage in the activities they want to, have to or need to do. Burn injuries primarily impact the skin however burn injuries which are deep dermal or full thickness in depth have the potential to disrupt underlying structures such as muscle, tendon, and bone. This depth of burn injury requires surgery to achieve wound closure in an optimal time, although this does result in scarring. Scarring resulting from burn injuries is known as hypertrophic scarring with features of reduced pliability, increased height, and vascularity. The contractile forces resulting from hypertrophic scarring can cause tightness leading to reduced hand function for the individual with a hand burn injury. This PhD program evolved from a clinical problem. Individuals with hand burn injuries reported that their hand was “not right”, and this was not consistent with their otherwise normative scores on standardised outcome measures. This disconnect in self-reported outcomes and standardised outcome measures prompted the PhD candidate to question the outcome measures used in practice and enrol in a PhD degree. The impetus was to address the clinical problem and either identify or develop a specific outcome measure for hand burn injuries. The program of research was a pragmatic, iterative process, that is the second thesis aim was directed by the findings of the first thesis aim. The first thesis aim was to investigate hand burn outcome measurement from an evidence-based perspective including: research evidence (objective 1), specialist clinicians (objective 2) and consumers (objective 3). The second aim of this thesis was to co-design (objective 4) and establish the preliminary psychometric properties (objective 5) of an outcome measure specific for hand burn injuries. [...]