Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation.
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
19
07
2019
revised:
14
11
2019
accepted:
22
11
2019
pubmed:
10
12
2019
medline:
29
7
2021
entrez:
10
12
2019
Statut:
ppublish
Résumé
The reorganization of acute major trauma pathways in England has increased survival following traumatic injury, resulting in an increased patient population with diverse and complex needs requiring specialist rehabilitation. However, national audit data indicate that only 5% of patients with traumatic injuries have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. This group concept mapping project aimed to identify the clinical service needs of individuals accessing our major trauma rehabilitation service, prioritize these needs, determine whether each of these needs is currently being met, and plan targeted service enhancements. Participants contributed towards a statement generation exercise to identify the key components of rehabilitation following major trauma, and individually sorted these statements into themes. Each statement was rated based on importance and current success. Multi-dimensional scaling and hierarchical cluster analysis were applied to the sorted data to produce themed clusters of ideas within concept maps. Priority values were applied to these maps to identify key areas for targeted service enhancement. Fifty-eight patients and health care professionals participated in the ideas generation activity, 34 in the sorting, and 49 in the rating activity. A 7-item cluster map was agreed upon, containing the following named clusters: Communication and Coordination; Emotional and psychological wellbeing; Rehabilitation environment; Early rehabilitation; Structured therapy input; Planning for home; and Long-term support. Areas for targeted service enhancement included access to timely and adequate information provision, collaborative goal setting, and specialist pain management across the rehabilitation pathway. The conceptual framework presented in this article illustrates the importance of a continuum of rehabilitation provision across the injury trajectory, and provides a platform to track future service changes and facilitate the codesign of new rehabilitation interventions for individuals following major trauma.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1436-1447Subventions
Organisme : Versus Arthritis
ID : 22026
Pays : United Kingdom
Organisme : The Newcastle upon Tyne Hospitals NHS Foundation Trust
Informations de copyright
© 2019 John Wiley & Sons, Ltd.
Références
National Audit Office. Major Trauma Care in England. London: The Stationery Office; 2010.
World Health Organization Department of Violence, Injury Prevention and Disability. Violence, Injuries and Disabilities: Biennial Report 2010-2011. Geneva, Switzerland: WHO:2012.
Kellezi B, Baines DL, Coupland C, et al. The impact of injuries on health service resource use and costs in primary and secondary care in the English NHS. J Public Health. 2015;38:e464-e471.
Kendrick D, Vinogradova Y, Coupland C, et al. Getting back to work after injury: the UK Burden of Injury multicentre longitudinal study. BMC Public Health. 2012;12:584.
Black C. Working for a Healthier Tomorrow. Dame Carol Black's Review of the Health of Britain's Working Age Population. London: TSO; 2008.
Black C, Frost D. Health at Work: An Independent Review of Sickness Absence. London: TSO; 2011.
Dinh M, Bein K, Gabbe B, et al. A trauma quality improvement project associated with improved patient outcomes: 21 years of experience at an Australian Major Trauma Centre. Injury. 2014;45:830-834.
Truchon C, Moore L, Belcaid A, et al. Shaping quality through vision, structure and monitoring of performance and quality indicators: impact story from the Quebec Trauma Network. Int J Technol Assess Health Care. 2017;33:1-5.
Moran CG, Lecky F, Bouamra O, et al. Changing the system - major trauma patients and their outcomes in the NHS (England) 2008-17. EClinicalMedicine. 2018;2-3:13-21.
Irwin J, Carter A. Major trauma patients with musculoskeletal injuries: rehabilitation pathway inadequacies. Int J Ther Rehabil. 2013;20:376-377.
Trochim W. An introduction to concept mapping for planning and evaluation. Eval Program Plann. 1989;12:1-16.
Anderson LA, Slonim A, Yen IH, et al. Developing a framework and priorities to promote mobility among older adults. Health Educ Behav. 2014;41:10S-18S.
Hackett KL, Lambson RL, Strassheim V, Gotts Z, Deary V, Newton JL. A concept mapping study evaluating the UK's first NHS generic fatigue clinic. Health Expect. 2016;19:1138-1149.
van Grieken RA, Kirkenier ACE, Koeter MWJ, Nabitz UW, Schene AH. Patients' perspectives on self-management in the recovery from depression. Health Expect. 2013;18:1339-1348.
Hackett KL, Dean KHO, Newton JL, et al. Mixed-methods study identifying key intervention targets to improve participation in daily living activities in Primary Sjorgren's Syndrome Patients. Arthritis Care Res. 2018;70:1064-1073.
McFall SL, Mullen PD, Byrd TL, et al. Treatment decisions for localized prostate cancer: a concept mapping approach. Health Expect. 2014;18:2079-2090.
Leyshon R, Shaw L. Using multiple stakeholders to define a successful return to work: a concept mapping approach. Work. 2012;41:397-408.
Kane M, Trochim WM. Concept Mapping for Planning and Evaluation. London: Sage; 2007.
De Kok M, Scholte RW, Sixma HJ, et al. The patient's perspective of the quality of breast cancer care: the development of an instrument to measure quality of care through focus groups and concept mapping. Eur J Cancer. 43(8):1257-1264.
Rosas SR, Kane M. Quality and rigor of the concept mapping methodology: a pooled study analysis. Eval Program Plann. 2012;35:236-245.
Turner-Stokes L. First Report of the National Clinical Audit of Specialist Rehabilitation Following Major Injury. London: NCASRI Project Team; 2016.
Claydon JH, Robinson L, Aldridge SE. Patients' perceptions of repair, rehabilitation and recovery after major orthopaedic trauma: a qualitative study. Physiotherapy. 2017;103:322-329.
Harms L, Talbot M. The aftermath of road trauma: survivors' perceptions of trauma and growth. Health Soc Work. 2007;32:129-137.
van Seben R, Smorenburg SM, Buurman BM. A qualitative study of patient-centred goal-setting in geriatric rehabilitation: patient and professional perspectives. Clin Rehabil. 2018;33:128-140.
Kessler D, Walker I, Sauve-Schenk K, Egan M. Goal setting dynamics that facilitate or impede a client-centred approach. Scand J Occup Ther. 2018;26(5):315-324.
Ahmadi A, Bazargan-Hejazi S, Zadie ZH, et al. Pain management in trauma: a review study. J Inj Violence Res. 2016;8:89-98.
Archer KR, Abraham CM, Obremskey WT. Psychosocial factors predict pain and physical health after lower extremity trauma. Clin Orthop Relat Res. 2015;473:3519-3526.
Breivek H, Collett B, Ventafidda V, Cohen R, Gallacher D. Survey of chronic pain in Europe; prevalence, impact on daily life and treatment. Eur J Pain. 2006;10:287-333.
National Institute for Health and Care Excellence. Major Trauma: Assessment and Initial Management. London: NICE; 2016.
Royal College of Anaesthetists. Core Standards for Pain Management Services in the UK. London: RCA; 2015.
Watkinson P, Wood AM, Lloyd DM, Brown GDA. Pain ratings reflect cognitive context; a range frequency model of pain perception. Pain. 2013;154:742-749.
Vincent HK, Horodyski M, Vincent KR, Brisbane ST, Sadasivan KK. Psychological distress after orthopaedic trauma: prevalence in patients and implications for rehabilitation. PM R. 2015;7:978-989.
Huang A, Katz J, Clark H. Ensuring safe prescribing of controlled substances for pain following surgery by developing a transitional pain service. Pain Manag. 2105;5:97-105.
Friedman-Sanchez G, Griffin JM, Rettmann NA, Rittman M, Partin MR. Communicating information to families of polytrauma patients: a narrative literature review. Rehabil Nurs. 2008;33:206-213.
Onwuegbuzie AJ, Leech NL. Sampling designs in qualitative research: making the sampling process more public. Qual. Rep. 2007;12(2):238-254.