Patient Experiences of Acute and Postacute Care After Trauma.


Journal

The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340

Informations de publication

Date de publication:
11 2023
Historique:
received: 11 01 2023
revised: 13 04 2023
accepted: 19 06 2023
medline: 11 9 2023
pubmed: 28 7 2023
entrez: 28 7 2023
Statut: ppublish

Résumé

Traumatic injury can transform a healthy, independent individual into a patient with complex health needs. Little is known about how injured patients understand their health and healthcare needs during postacute recovery, limiting our ability to optimize care. This multiple-methods study explored injured patients' experiences of care up to 30 days after discharge. Injured adults admitted to an urban, Level I trauma center August 1, 2019-November 30, 2020 were sampled purposively to balance blunt and penetrating injuries. Patient experience and health status were assessed at baseline and 30 days postdischarge using the Quality of Trauma Care Patient-Reported Experience Measure. Fifteen qualitative interviews were conducted with a purposive subset and analyzed using qualitative content analysis. Of 67 participants (76% male, 73% Black, 51% penetrating, median age 34 years), 37 completed follow-up surveys. Quality of acute care was rated 9-10/10 by 81% of the sample for acute and 65% for postacute care (P = 0.09). Thirty percent described fair or poor mental health, but only mental health concerns were addressed for only 2/3. Pain control was inadequate in 31% at baseline and for 46% at follow-up (P = 0.09). Qualitative analysis revealed general satisfaction with acute care but challenges in recovery with unmet needs for communication and care coordination. Trauma patients appreciated the quality of their acute care experiences but identified opportunities for improvement in prognostic communication, pain management, and mental health support. Unmet mental and physical care needs persist at least 1 month after hospital discharge and reinforce the need for interventions that optimize postacute trauma care.

Identifiants

pubmed: 37506429
pii: S0022-4804(23)00272-X
doi: 10.1016/j.jss.2023.06.020
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

303-312

Subventions

Organisme : NCIPC CDC HHS
ID : R49 CE003083
Pays : United States

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Elinore J Kaufman (EJ)

Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: elinore.kaufman@pennmedicine.upenn.edu.

Gregory Whitehorn (G)

Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Whitney Orji (W)

University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Kristen Chreiman (K)

Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Sunny Jackson (S)

Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Daniel Holena (D)

Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Meghan Lane-Fall (M)

Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Sara F Jacoby (SF)

University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.

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Classifications MeSH