Dy Christopher J, Brogan David M, Rolf Liz, Ray Wilson Z, Wolfe Scott W, James Aimee S
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA.
Bone Jt Open. 2021 Jan 3;2(1):9-15. doi: 10.1302/2633-1462.21.BJO-2020-0175.R1. eCollection 2021 Jan.
Brachial plexus injury (BPI) is an often devastating injury that affects patients physically and emotionally. The vast majority of the published literature is based on surgeon-graded assessment of motor outcomes, but the patient experience after BPI is not well understood. Our aim was to better understand overall life satisfaction after BPI, with the goal of identifying areas that can be addressed in future delivery of care.
We conducted semi-structured interviews with 15 BPI patients after initial nerve reconstruction. The interview guide was focused on the patient's experience after BPI, beginning with the injury itself and extending beyond surgical reconstruction. Inductive and deductive thematic analysis was used according to standard qualitative methodology to better understand overall life satisfaction after BPI, contributors to life satisfaction, and opportunities for improvement.
Among the 15 patients interviewed, the following themes emerged: 1) happiness and life satisfaction were noted despite limitations in physical function; 2) quality of social support influences life satisfaction during recovery from BPI; and 3) social participation and having a sense of purpose impact life satisfaction during recovery from BPI.
How patients perceive their BPI treatment and recovery varies widely, and is not directly linked to their self-reported functional outcome. Patients with stronger social circles and activities that give them a sense of fulfillment were more likely to be satisfied with their current status. Evaluating a patient's social network, goals, and potential supportive adaptations early in the treatment timeline through coordinated multidisciplinary care may improve overall satisfaction during recovery from BPI.Cite this article: 2020;2(1):9-15.
臂丛神经损伤（BPI）是一种常具有毁灭性的损伤，会对患者的身体和情感造成影响。绝大多数已发表的文献基于外科医生对运动结果的分级评估，但BPI后的患者体验尚未得到充分了解。我们的目的是更好地了解BPI后的总体生活满意度，以便确定在未来的护理中可以解决的问题领域。
我们对15例初次神经重建后的BPI患者进行了半结构化访谈。访谈指南聚焦于BPI后患者的体验，从损伤本身开始，延伸至手术重建之后。根据标准定性方法进行归纳和演绎主题分析，以更好地了解BPI后的总体生活满意度、生活满意度的影响因素以及改进的机会。
在接受访谈的15名患者中，出现了以下主题：1）尽管身体功能存在限制，但仍能感受到幸福和生活满意度；2）社会支持的质量会影响BPI恢复期间的生活满意度；3）社会参与和有目标感会影响BPI恢复期间的生活满意度。
患者对其BPI治疗和恢复的认知差异很大，且与他们自我报告的功能结果没有直接关联。社交圈子较强且有能带来成就感活动的患者更有可能对自己的现状感到满意。在治疗过程早期通过协调多学科护理评估患者的社交网络、目标和潜在的支持性适应措施，可能会提高BPI恢复期间的总体满意度。引用本文：2020；2（1）：9-15。
