A first-of-its-kind study on injury recovery has taken the trauma patient’s point of view, according to the team of nursing researchers behind it.
They said that understanding how trauma patients defined successful outcomes was key to enhanced patient care and research.
“Asking trauma patients what they consider to be priorities of care and recovery has been neglected”
The international research partnership included the University of Pennsylvania school of nursing in the US and Griffith University school of nursing and midwifery in Australia.
The study, recently published in the journal Injury, involved 33 trauma patients, 22 family members and 40 clinicians from trauma departments in two Australian teaching hospitals.
It focused on two areas – firstly, learning what patients, family members and clinicians considered to be the indicators of successful recovery from an acute admission after traumatic injury.
Secondly, it looked at understanding if these indicators differed between these groups of stakeholders or changed over time, from during admission to three months after discharge.
Participants in the study identified five specific indicators of recovery, including returning to work, resuming family roles, achieving independence, recapturing normality and achieving comfort.
“Understanding different perceptions in relation to outcomes is particularly important in trauma”
Trauma patients articulated the most detail in these indicators, compared to the responses from the study’s other participant groups, said the researchers.
They noted that perceptions of indicators of injury recovery changed for some participants over the three months after they were discharged.
These changes fell into three broad groups, which the study authors defined as “increasing recognition that activities of daily living were important, increasing realisation of the impact of the injury, and unfolding appreciation that life could not be taken for granted”.
While in the hospital, trauma patients in the study often noted the desire to be able to care for themselves.
However, the researchers noted that the practical implications of their physical limitations did not fully reveal themselves to patients until after discharge.
Instead, the “ripple effects” of limitations in their abilities to undertake basic self-care activities or have full range of movement of their limbs became increasingly apparent within the first month of being at home, the researchers found.
Study author Professor Therese Richmond, from Pennsylvania University, said: “While it is recognised that focusing on what patients envision to be good outcomes is an important part of patient-centred care, asking trauma patients and their families what they consider to be the priorities of care and recovery has been neglected.
Study focuses on injury recovery from trauma patient’s view
Source: Penn Nurisng and City, University of London
“Changes in expectations and priorities over time have implications for how we provide education and support that should be tailored to different phases in the recovery trajectory,” she said. “As patients and family members change their expectations over time, appropriate care needs to be provided across the care continuum.”
Lead study author Professor Leanne Aitken, who is now based at City University in London, said: “Understanding different perceptions in relation to outcomes is particularly important in trauma, where patients may not be able to participate in decision making for a period of their hospitalisation.”
She added: “It is expected that by understanding what matters to patients and family members will help us empower patients to be active participants in the healthcare process and will underpin development of patient-reported outcomes that should be used in practice and research in trauma care.
“This information will also inform future trauma outcome research to ensure these priority areas are appropriate for a broader range of participants,” she said.