Trauma Patients’ Personal Experience Essay Assignment Paper

Major trauma is the term used to describe a serious injury that could cause permanent disability or death¹(Nice Guideline, 2016). According to National Confidential Enquiry into Patient Outcome and Death (NCEPOD), 2007, it is the fourth largest cause of death in the UK, and the number one cause of death in the first four decades of life⁷.Trauma Patients’ Personal Experience Essay A series of recent high-profile reports, including the National Audit Office (NAO)’s Major trauma care in England, has made trauma a national priority for the NHS (8. Implementing trauma systems: Key issues for NHS). There has been focus on developing trauma care in the last few years with the National Health Service (NHS) Outcomes Framework (Department of Health (DoH) 2013)⁶Domain 3 being focused on survival for major trauma. In order to improve and further develop high-quality trauma care, trauma centres need to review their activities continuously and patients’ experiences should be mandatory in such an evaluation.⁵

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As good trauma care involves getting the patient to the right place at the right time for the right care (NHS UK, 2014), major trauma centres (MTC) are set up to provide the specialized care with doctors from multidisciplinary specialization. Effective and Rapid treatment of trauma patients is important for reducing short-term as well as long-term mortality and morbidity ^[2–4] and for avoiding physical, psychological and financial impact to the patients as well as to their family members.Trauma Patients’ Personal Experience Essay The initial assessment of major trauma patients’ is challenging with minutes making the difference between life and death and this involves rapidly identifying injuries, completing investigations and accessing specialist care as soon as possible after arriving the hospitals.⁹ After the emergency resuscitation procedures, when the patient becomes stable in his own condition, he will be transferred to the ward for further routine medical treatment until discharge.

Many studies had been done concerning with trauma patients at emergency department. O’ Brien and Fothergill- Bourbonnais (2004) explored that a dynamic combination of efficiency and caring on the part of trauma team members created an environment in which patients felt safe ¹⁰. Jay (1996) described that touch, company and information were important in coping and regaining control as well as the need to trust the healthcare professionals¹¹. Other studies of Franzen et al (2008) and Wiman et al (2006) presented that participants were more confident, satisfied and gained comfort from professionals who treated them with both good physical care and psycho-social care¹². Despite the previous great studies about the trauma patient care at emergency department, little is known about the actual encounter of major trauma patients on the full trauma team care of emergency departments in UK. Basically, realizing the needs of major trauma patients during their admission at major trauma centers is necessary to make improvement of existing emergency departments in the UK.

2. METHOD

2.1. Aim and Objectives

The aim of this study was to understand the trauma patients’ personal experience of trauma center during the emergency and then at the stable periods.

The objectives of this study were to narrate the real image of major trauma patients at emergency centers, to realise their needs in receiving the health services of emergency departments and to listen to their feedbacks which would be helpful in developing high quality trauma care centers in the UK.Trauma Patients’ Personal Experience Essay

2.2. Design and Setting

This study was a qualitative interview study designed to capture the major trauma patients’ admitted experience at emergency departments. The study had a hermeneutic phenomenological approach¹⁴ as the researcher considered that being the major trauma patient at ED can reflect the real situation and needs of the patients at the major trauma centers (MTC) in the UK. In the methodology of Van Manen, a phenomenological descriptive sensitivity is combined with an interpretive understanding of the lived experience and how this is given meaning. Hermeneutic phenomenology is the study of life world and may be accessed and studied through the four lifeworld essentials; live body, lived time, lived space, and lived other. These existentials are described as the fundamental structure of every person’s lifeworld.¹⁴

This qualitative study was conducted at a trauma ward of Major Trauma Center (MTC) of National Health Service (NHS) in London, UK.

2.3 Study Context and Participants

Ten patients admitting to the trauma ward after receiving full major trauma care of MTC were interviewed. The participants were selected by using the pragmatic convenience sample irrespective of gender, ethnicity and socioeconomic status allowing to include a diverse group of patients if they fit with the inclusion and exclusion criteria.

Inclusion criteria were: (1) Age- 18 years or older (2) Major Trauma Patient (ISS- 16 or greater) (3) Glasgow Coma Scale Score- 13 or above (4) Revised Trauma Score- 10 or above (5) trauma code ¹⁵ initiated in the emergency department (6) physically and cognitively capable of participating in an interview in English (7) Required admission to hospital.Trauma Patients’ Personal Experience Essay Those who comatose or sedated during the initial trauma treatment, who were still having severe illness physically or mentally, who admitted directly to intensive care unit or discharged from the ED were excluded from the study.

All patients admitted at the trauma ward at the time of study were considered and a member of trauma care team selected the potential participants based on their medical condition, inclusion and exclusion criteria. Then, they were invited to get involve in the study by letting know the aim as well as potential benefit of the study and those that agreed to see the researcher were approached. The researcher did not have access to the patients’ medical records, so all mechanism of injury, diagnosis and personal experience of health services were according to the patients’ understanding. Each patient was assigned a pseudonym.

2.4 Ethical Consideration

The ethical issues concerned with this study was the confidentiality of the patient and emotional distress that could be resulted by reflecting frustrating traumatic event again. The researcher was a fulltime MSc Health Management student during the study and identified herself as being independent from the hospital or providing trauma care in the ED. Before each interview, written informed consent form was obtained from every single patient and for the sake of participant’s confidentiality, a code was given to each form and used for further data processing. Consent forms and data were kept separately. The impact of discussing a sensitive topic was reassured by informing the patient that participation was voluntary and that consent could be withdrawn at any time without jeopardizing their treatment or care.Trauma Patients’ Personal Experience Essay

2.5 Interview and Data Collection

One-on-one semi-structured tape-recorded interviews were conducted as soon as the patient felt they could participate in the interview session ranging between first and third weeks after the injury event. The reason behind semi-structured interview was to know the actual experience and feedbacks of trauma patients within the boundary of research aim and objectives. In response to several patients’ expressed concern that they did not know where to begin in telling their story starting from the initial arrival to ED to trauma ward, open-ended questions were asked to explore their emotional, medical and social encounters at the time of emergency as well as during their stable period. Questions such as “Can you talk me through what you remember about arriving in A & E” “Can you remember how you were feeling when it first happened” were asked. Follow up questions, “Can you give an example” “What was it that made you feel like you were in good hands”, were used to clarify thoughts, feeling and experiences if this information did not appear in the narrated story ¹⁶. Finally, participants were asked what they would change at the emergency department for their feedbacks and opinion. Each interview lasted from 30 to 60 mins and were transcribed verbatim.Trauma Patients’ Personal Experience Essay

2.6. Data Analysis

Data analysis of this study followed Colaizzi’s analytical approach: abstracting approach: abstracting from patients’ words to formulate the essential meanings in the experiences; meanings were then grouped into categories, and finally themes emerged¹⁷. After several readings, transcripts were analysed line by line to identify key words and phrases that were subsequently color coded. Codes were operationally defined to be consistent throughout the study¹⁰. The codes were grouped into categories and sub categories. Truth-value, applicability, consistency, and neutrality were used in this study to ensure trust worthiness of the data and subsequent analysis^10,17.Trauma Patients’ Personal Experience Essay

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Trauma Patients’ Personal Experience Essay Assignment Paper

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