Objective: Unintentional injuries such as road traffic injuries constitute a major facet of health and disability in low-and middle-income countries. Survivors of moderate or severe unintentional injuries are at risk of psychological distress, although many people show resilience during recovery. This article describes the experience and contributing factors of psychological distress and resilience over the course of recovery among unintentional injury survivors in urban Kenya. Method: We examined the various social and mental health consequences over the course of injury and recovery through conducting in-depth interviews with 28 survivors of unintentional injuries in Nairobi, Kenya, 4Ϫ8 months after the injury. Respondents were purposively sampled based on reported depressive and anxiety symptoms through structured questionnaire interviews in the parent study. Inductive thematic coding was performed on transcribed and translated interviews using ATLAS.ti, upon which the conservation of resources theory was identified as the most relevant theory to facilitate the understanding and presentation of the findings. Results: Several types of resource loss were described, including financial, property, condition (e.g., employment, marriage), and physical health resources at different phases of recovery. Social support (in terms of materials and emotional support) through family, friends, neighbors, church members, spirituality, personal resources, and improvement in physical condition contributed to the adaptation and resilience. Conclusions: Potential interventions on building a more formalized follow-up support system and provision of social services early in the treatment phase is important to prevent additional resource losses to help reduce distress and improve psychosocial and physical functioning.
Impact and ImplicationsThe burden of unintentional injuries is disproportionately higher in low-and middle-income countries. This qualitative study extends the understanding of contributing factors of psychological distress and resilience through different phases after injury in an urban low-resource context. The loss and gain of resources are presented using Hobfoll's conservation of resources theory to understand the dynamic contexts after injury in relation to psychological distress. Efforts are needed to identify loss spirals early in the rehabilitation process and enhance resource gain through social support and network strengthening to promote resilience in the process of recovery.