The experience of emotional wellbeing for patients with physical injury: A qualitative follow-up study

Wiseman, Taneal; Foster, Kim; Curtis, Kate

doi:10.1016/j.injury.2016.03.021

Cited by 27 publications

(41 citation statements)

References 8 publications

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“…To counteract restricted conclusions, that is, to better grasp the complexity of emotional aspects and understand what is important and helpful to hospitalized trauma victims, there is a need for qualitative studies exploring experiences from the hospital (Gooberman- Hill & Fox, 2011). Although they are few, some such studies, mostly studying survivors of accidental traumatic injury, have been carried out, reporting on issues such as processing of the traumatic experiences, negotiating the sense of safety and self, and distress related to medical procedures Ogilvie et al, 2015b;Olive, 2017;Oyesanya, 2017;Reisenhofer & Seibold, 2013;Wiman, Wikblad, & Idvall, 2007;Wiseman, Foster, & Curtis, 2016). In some studies also, psychosocial hospital care for traumatic injury survivors has been qualitatively explored from the perspective of the family (Ogilvie, Foster, McCloughen, & Curtis, 2015a) and the staff (Alisic, Conroy, Magyar, Babl, & O'Donnell, 2014).…”

Section: Early Psychosocial Trauma Care In the Hospitalmentioning

confidence: 99%

Psychosocial care for hospitalized young survivors after the terror attack on Utøya Island: A qualitative study of the survivors’ experiences

Bugge

Jensen

Nilsen

et al. 2019

Injury

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The origin of the project One peaceful summer day in 2011, Friday the 22nd of July, Norway was hit by two devastating terrorist attacks. A man, dressed as a police officer, detonated a bomb outside the Oslo government building and then entered a political summer camp for adolescents and young adults at Utøya Island one hour's drive outside Oslo. Heavily armed, he hunted down and targeted the camp participants. The perpetrator killed 77 people, eight in the bomb attack and 69 in the Utøya shooting attack. In total, more than 150 victims sustained physical injuries. Ten survivors from the bomb attack and 33 survivors from the Utøya attack were hospitalized due to physical injuries at Oslo University Hospital (OUS) and at local hospitals situated near Utøya Island (Vestre Viken Hospital Trust). Since 2008, I had been working as a child and adolescent psychiatrist at OUS, Department of Child and Adolescent Mental Health in Hospital (S-BUP). Through my daily work, I had met medically ill or injured children and adolescents struggling with how to live with their compromised bodies. Being at work during the critical days in July 2011, I became part of the psychosocial crisis team that was mobilized to handle the extraordinary situation. The psychiatrists, psychologists, nurses, and social workers in the team contributed to providing psychosocial care for the hospitalized youths and their families. We sought to offer empathetic and practical support with a focus on rebuilding the feeling of safety and stabilization of affects and arousal. The team also provided support and supervision to the regular health care personnel. For me, many questions arose subsequently: Was our support helpful? What was important for the youths in this profoundly stressful situation? Would they cope with their challenges of distress and grief, and how would the psychological and physical trauma affect their health over time? Trond H. Diseth, who took part in organizing the psychosocial support in the hospital, and I applied for funding of this doctoral dissertation focusing on the physically injured survivors of the Utøya shooting attack. The project was developed as a part of the Utøya study led by principal investigator Grete Dyb at the Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS). From August 2013, I started my PhD project and took part in the Utøya project group at NKVTS contributing to the conduction of the study. The Faculty of

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Section: Early Psychosocial Trauma Care In the Hospitalmentioning

confidence: 99%

Psychosocial care for hospitalized young survivors after the terror attack on Utøya Island: A qualitative study of the survivors’ experiences

Bugge

Jensen

Nilsen

et al. 2019

Injury

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“…Living in the present, a 'wait and see' approach and focusing on small obtainable goals has been noted as helpful in early recovery from trauma. 59 Later on in recovery, the sense of uncertainty through closeness to injury and death can be experienced as heightened awareness of potential danger 60 and changing activities to minimise danger. 51 Strategies to help participants to process anxiety and fear created by injury and continued treatment such as counselling or coaching may help them make sense of uncertainty within the context of their life.…”

Section: Living With Uncertaintymentioning

confidence: 99%

“…They also felt that emotional recovery was not highly valued within trauma services. 60 The experience of overwhelming strong emotions as a result of injury suggests that emotional suffering needs a higher profile alongside physical suffering and an exploration of interventions that might be helpful for this group.…”

Section: Processing Strong Emotionsmentioning

confidence: 99%

Negative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT

Costa

Achten

Bruce

et al. 2018

Health Technol Assess

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Background Open fractures of the lower limb occur when a broken bone penetrates the skin and is exposed to the outside environment. These are life-changing injuries. The risk of deep infection may be as high as 27%. The type of dressing applied after surgical debridement could potentially reduce the risk of infection in the open-fracture wound. Objectives To assess the disability, rate of deep infection, quality of life and resource use in patients with severe open fracture of the lower limb treated with negative-pressure wound therapy (NPWT) versus standard wound management after the first surgical debridement of the wound. Design A pragmatic, multicentre randomised controlled trial. Setting Twenty-four specialist trauma hospitals in the UK Major Trauma Network. Participants A total of 460 patients aged ≥ 16 years with a severe open fracture of the lower limb were recruited from July 2012 through to December 2015. Patients were excluded if they presented more than 72 hours after their injury or were unable to complete questionnaires. Interventions Negative-pressure wound therapy (n = 226) where an ‘open-cell’ solid foam or gauze was placed over the surface of the wound and connected to a suction pump which created a partial vacuum over the dressing versus standard dressings not involving negative pressure (n = 234). Main outcome measures Disability Rating Index (DRI) – a score of 0 (no disability) to 100 (completely disabled) at 12 months was the primary outcome measure, with a minimal clinically important difference of 8 points. The secondary outcomes were deep infection, quality of life and resource use collected at 3, 6, 9 and 12 months post randomisaton. Results There was no evidence of a difference in the patients’ DRI at 12 months. The mean DRI in the NPWT group was 45.5 points [standard deviation (SD) 28.0 points] versus 42.4 points (SD 24.2 points) in the standard dressing group, giving a difference of –3.9 points (95% confidence interval –8.9 to 1.2 points) in favour of standard dressings (p = 0.132). There was no difference in HRQoL and no difference in the number of surgical site infections or other complications at any point in the 12 months after surgery. NPWT did not reduce the cost of treatment and it was associated with a low probability of cost-effectiveness. Limitations Owing to the emergency nature of the interventions, we anticipated that some patients who were randomised into the trial would subsequently be unable or unwilling to take part. Such post-randomisation withdrawal of patients could have posed a risk to the external validity of the trial. However, the great majority of these patients (85%) were found to be ineligible after randomisation. Therefore, we can be confident that the patients who took part were representative of the population with severe open fractures of the lower limb. Conclusions Contrary to the existing literature and current clinical guidelines, NPWT dressings do not provide a clinical or an economic benefit for patients with an open fracture of the lower limb. Future work Future work should investigate alternative strategies to reduce the incidence of infection and improve outcomes for patients with an open fracture of the lower limb. Two specific areas of potentially great benefit are (1) the use of topical antibiotic preparations in the open-fracture wound and (2) the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture. Trial registration Current Controlled Trials ISRCTN33756652 and UKCRN Portfolio ID 11783. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 73. See the NIHR Journals Library website for further project information.

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“…Thus, an effective starting point for rehabilitation is to understand the needs of the injured child and their family to enable an individualised approach to their care. Previous research, including our work to review needs following childhood injury, 8 highlighted a range of needs; particularly support with psychosocial problems for the injured child and their other family members, [8][9][10][11][12][13][14][15][16] as well as for physical and practical problems. 13 17 18 Support is required to facilitate the child's transitions from hospital to home, 19 and return to school.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Qualitative study of the needs of injured children and their families after a child’s traumatic injury

et al. 2020

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ObjectiveTo explore the needs of children and their families after a child’s traumatic injury.DesignSemi-structured qualitative interviews with purposeful sampling for different types of injuries and a theoretical thematic analysis.Participants32 participants; 13 children living at home after a traumatic injury, their parents/guardians (n=14) and five parents whose injured child did not participate.SettingTwo Children’s Major Trauma Centres (hospitals) in England.ResultsInterviews were conducted a median 8.5 months (IQR 9.3) postinjury. Injuries affected the limbs, head, chest, abdomen, spine or multiple body parts. Participants highlighted needs throughout their recovery (during and after the hospital stay). Education and training were needed to help children and families understand and manage the injury, and prepare for discharge. Information delivery needed to be timely, clear, consistent and complete, include the injured child, but take into account individuals’ capacity to absorb detail. Similarly, throughout recovery, services needed to be timely and easily accessible, with flexible protocols and eligibility criteria to include injured children. Treatment (particularly therapy) needed to be structured, goal directed and of sufficient frequency to return injured children to their full function. A central point of contact is required after hospital discharge for advice, reassurance and to coordinate ongoing care. Positive partnerships with professionals helped injured children and their families maintain a sense of hope and participate in joint decision making about their care.ConclusionThroughout the full trajectory of recovery injured children and their families need family centred, accessible, flexible, coordinated health services, with more effective harmonious, communication between professionals, the child and their family. There is a requirement for support from a single point of contact and a system that monitors the needs of the injured child and their family after hospital discharge.

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The experience of emotional wellbeing for patients with physical injury: A qualitative follow-up study

Cited by 27 publications

References 8 publications

Psychosocial care for hospitalized young survivors after the terror attack on Utøya Island: A qualitative study of the survivors’ experiences

Psychosocial care for hospitalized young survivors after the terror attack on Utøya Island: A qualitative study of the survivors’ experiences

Negative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT

Qualitative study of the needs of injured children and their families after a child’s traumatic injury

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