Important Issues to Severe Trauma Survivors
- 20 March 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 275 (1), 189-195
- https://doi.org/10.1097/sla.0000000000003879
Abstract
Objective: Identify issues that are important to severe trauma survivors up to 3 years after the trauma. Background: Severe trauma is the first cause of disability-adjusted life years worldwide, yet most attention has focused on acute care and the impact on long-term health is poorly evaluated. Method: We conducted a large-scale qualitative study based on semi-structured phone interviews. Qualitative research methods involve the systematic collection, organization, and interpretation of conversations or textual data with patients to explore the meaning of a phenomenon experienced by individuals themselves. We randomly selected severe trauma survivors (abbreviated injury score ≥3 in at least 1 body region) who were receiving care in 6 urban academic level-I trauma centers in France between March 2015 and March 2018. We conducted double independent thematic analysis. Issues reported by patients were grouped into overarching domains by a panel of 5 experts in trauma care. Point of data saturation was estimated with a mathematical model. Results: We included 340 participants from 3 months to 3 years after the trauma [median age: 41 years (Q1–Q3 24–54), median injury severity score: 17 (Q1–Q3 11–22)]. We identified 97 common issues that we grouped into 5 overarching domains: body and neurological issues (29 issues elicited by 277 participants), biographical disruption (23 issues, 210 participants), psychological and personality issues (21 issues, 147 participants), burden of treatment (14 issues, 145 participants), and altered relationships (10 issues, 87 participants). Time elapsed because the trauma, injury location, or in-hospital trauma severity did not affect the distribution of these domains across participants’ answers. Conclusions: This qualitative study explored trauma survivors’ experiences of the long-term effect of their injury and allowed for identifying a set of issues that they consider important, including dimensions that seem overlooked in trauma research. Our findings confirm that trauma is a chronic medical condition that demands new approaches to post-discharge and long-term care.Keywords
This publication has 46 references indexed in Scilit:
- Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma: a prospective cohort studyBMC Psychiatry, 2012
- Developing core outcome sets for clinical trials: issues to considerTrials, 2012
- Posttraumatic stress symptoms and health-related quality of life: a two year follow up study of injury treated at the emergency departmentBMC Psychiatry, 2012
- Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)Quality of Life Research, 2011
- The injury List Of All Deficits (LOAD) Framework – conceptualising the full range of deficits and adverse outcomes following injury and violenceInternational Journal of Injury Control and Safety Promotion, 2010
- Determinants of Long-Term Functional Consequences After Major TraumaThe Journal of Trauma and Acute Care Surgery, 2007
- How Many Interviews Are Enough?Field Methods, 2006
- Using thematic analysis in psychologyQualitative Research in Psychology, 2006
- Choosing Outcome Assessment Instruments for Trauma RegistriesAcademic Emergency Medicine, 2005
- Seasons of Survival: Reflections of a Physician with CancerThe New England Journal of Medicine, 1985