Sepahvand Elham, Khankeh Hamidreza, Hosseini Mohammadali, Akhbari Behnam
Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Research center of health in emergency and disasters, University of social welfare and rehabilitation sciences, Tehran, Iran.
J Med Life. 2019 Oct-Dec;12(4):419-425. doi: 10.25122/jml-2019-0078.
The injury management in the acute phase of spinal cord injury starts at the accident scene and focuses on preventing and reducing secondary damages. The road traffic injured patients are mostly transferred by relatives, untrained laypeople, and the drivers of heavy vehicles. The current study explored the experience of people with spinal cord injury in the accident scene. This was a qualitative content analysis study using the semi-structured interviewing method with an interview guide for data collection. Purposive sampling method was performed within ten months until data saturation. We used the constant comparative approach recommended by Corbin and Strauss (2015). In total, 15 people with spinal cord injury and bystanders participated in this study. The central theme extracted in this study was "emotional interaction" that referred to the emotional reactions in managing road traffic victims. Two main categories of "emotional intervention" with "emotional atmosphere," "desperation," "rescue efforts," subcategories and "scene shock" with "unplanned intervention," "emotional behavior," "emotional decisions," and "emotional involvement," subcategories were classified. The emotional atmosphere of the scene and stress level of the victim and the relatives, and the insistence of the victim to escape from the harsh condition have caused those lacking medical knowledge and expertise to transfer the patient unsafely. This resulted in secondary damages, like aggravated spinal cord injury or even caused the spinal cord injury.
脊髓损伤急性期的损伤管理始于事故现场，重点是预防和减少继发性损伤。道路交通受伤患者大多由亲属、未经培训的外行人员和重型车辆司机转运。本研究探讨了脊髓损伤患者在事故现场的经历。这是一项定性内容分析研究，采用半结构化访谈方法，并使用访谈指南收集数据。在十个月内采用目的抽样法，直至数据饱和。我们采用了Corbin和Strauss（2015年）推荐的持续比较法。共有15名脊髓损伤患者和旁观者参与了本研究。本研究提取的中心主题是“情感互动”，指的是在处理道路交通受害者时的情感反应。将“情感干预”分为“情感氛围”、“绝望”、“救援努力”等子类别，以及“现场冲击”分为“无计划干预”、“情感行为”、“情感决策”和“情感参与”等子类别。现场的情感氛围、受害者及其亲属的压力水平，以及受害者逃离恶劣状况的坚持，导致缺乏医学知识和专业技能的人员不安全地转运患者。这导致了继发性损伤，如脊髓损伤加重，甚至导致脊髓损伤。
