Injury representations and their association with recovery outcomes in adults with traumatic orthopaedic injuries: protocol for a scoping review v1

Abstract

IntroductionTraumatic orthopaedic injuries contribute substantially to the burden of disability worldwide.The majority oftraumatic orthopaedic injuries are classified as mild-moderate in severity and affect the extremities. A subset of people with these injuries continue to experience pain and/or distress long after the injury has healed, with personal, societal and economic impacts. We are yet to fully understand the mechanisms underlying non-recovery after traumatic orthopaedic injuries in adults. Cognitive models or representations of a health threat, such as an injury, have been associated with pain and distress in people with traumatic orthopaedic injuries. However,there are currently no reviews that comprehensivelyexamine the association between injury beliefs or representations and recovery outcomes. Objectives Wewill conduct a scoping review with the primary aim of mappingtheliterature examining associations betweeninjurybeliefs orrepresentationsand recovery outcomes.This review will use Leventhal, Meyer andNerenz’s'Common Sense Model of Illness Representations' as a guiding conceptual framework. The secondary aims of this review are to characterise injury representations in adults with traumatic orthopaedic injuries;to determine what biological, psychological and social factors are associated with injury representations;and to describe associations between injury representations and recovery-related outcomes, specifically pain, distress and disability. Methods and analysis This protocol has been written in accordance with the Joanna Briggs Methodology for scoping review protocols. The review will include studies examining injury representations or closely related constructs in adults with traumatic orthopaedic injuries,at any point in time since the original injury. Studies on adults with traumatic brain injuries, Whiplash Associated Disorder, Spinal Cord Injuries, burns or injuries fromlowfallsin adults aged over 65 years of age. There will be no limits on geographical location or healthcare setting. The following databases will be used: Medline (EbscoHost), PsycINFO,Embaseand CINAHL. Grey literature searches will also be conducted. Two reviewers will independently screen the articles and extract the data. Results will be presented in tabular form, together with a narrative summary addressing the primary aims of the review.