Understanding and meeting information needs following unintentional injury: Comparing the accounts of patients, carers and service providers

Abstract

Abstract:OBJECTIVE: To explore information needs of unintentional injury patients and their carers over time, across services, and how such needs are met from the perspectives of patients, carers and service providers.METHODS: Qualitative nested study within a multi-centre longitudinal study quantifying psychosocial, physical, occupational outcomes and service use and costs following a range of unintentional injuries. Semi-structured interviews conducted with 45 patients during the first year post injury, 18 of their carers and 40 providers of services.RESULTS: Patients and carers needed information about the nature and severity of injury, prognosis, self-management and further services. Information needs changed over time with the biggest difficulties being during transfer from primary to secondary care. Barriers to information provision included service providers' time limitations and uncertainty around information provision, and patients' reluctance to ask for information or inability to process it. Suggested improvements included provision of reassurance as well as factual information, information about further services, earlier follow-up, increased appointment times and greater involvement of families where appropriate. This is an accepted manuscript of an article published by Elsevier in 'Injury' available online at http://www.sciencedirect.com/science/article/pii/S0020138314006305?via%3Dihub It is not the copy of record. Copyright © 2017, Elsevier 2 CONCLUSIONS: The information needs of patients and carers post injury change with time and there are a number of ways to remove gaps and barriers in current provision to meet such needs.PRACTICE IMPLICATIONS: Providing information on injury management, prognosis and available services and reassurance at each stage of the recovery process in secondary care and when transferring to primary care would be helpful for patients and carers. A follow-up contact soon after discharge and the opportunity to ask questions could be beneficial. Better information about the patient's needs and ways they can help could help carers fulfil their caring role.

Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care

“…15 Patient and SP sampling is described in full elsewhere. 9,10 Patient interview schedules explored experiences of care post-injury while SP interviews explored experiences of providing care and individual and organisational barriers to better provision. Patient interviews were undertaken in the participant's home or by telephone.…”

“…8 Discharge home after an injury can be a difficult time and many patients report feeling inadequately prepared. 9 Contributory factors are: poorly coordinated or long waiting times for care, 10 inadequate pain control, 8,11 psychological problems, 12-14 lack of access to services, 10,11 and significant gaps in information provision. 9 Post-injury, most working-age adults consult a GP in the first month and over a third consult between 1 and 4 months.…”

“…9 Contributory factors are: poorly coordinated or long waiting times for care, 10 inadequate pain control, 8,11 psychological problems, 12-14 lack of access to services, 10,11 and significant gaps in information provision. 9 Post-injury, most working-age adults consult a GP in the first month and over a third consult between 1 and 4 months. 8 Little is known, however, about patient and service provider (SP) experiences and views about post-hospital care and the role of GPs.…”

The impact of psychological factors on recovery from injury: a multicentre cohort study

“…Health professionals routinely treating people with unintentional injuries are not mental health experts. It would be useful if they can identify patients at risk of poor recovery using standard self-report measures of psychological health and pain, help patients manage these conditions and refer to appropriate services as necessary [50, 51]. In addition, our study shows a simple and routinely available measure, such as the number of nights in hospital, can highlight those at risk of poor recovery.…”

The role of general practice in following up patients with trauma

“…They need help understanding what has happened and their projected recovery, adequate symptom control, and a joined up health care system supporting timely access to rehabilitation. Although budget restraints or provision of services may affect local access to therapies, simply meeting regularly with patients soon after the injury, providing detailed verbal and written information and reassurance, 6 and suggesting practical solutions and strategies on how to cope with symptoms or a gradual return to work can help reduce psychological distress and promote recovery. 7 Ponsford et al demonstrated that giving patients who had sustained a minor head injury an information booklet 1 week post injury resulted in significantly lower rates of stress at 3 months than those who did not receive the booklet.…”