Emory University School of Medicine, Atlanta, GA, USA.
Grady Health System, Atlanta, GA, USA.
Am Surg. 2023 Sep;89(9):3732-3738. doi: 10.1177/00031348231171121. Epub 2023 May 6.
Despite a high prevalence of retained bullet fragments (RBFs) after firearm related injury (FRI) there is limited data on the full spectrum of their consequences, particularly the psychological impacts on those injured. Further, the experiences of FRI survivors with RBFs are missing from existing literature. The objective of this study was to explore the psychological impacts of RBFs on individuals who have experienced recent FRI.
Adult (18-65 years) survivors of FRI with radiographically confirmed RBFs were purposively selected from an urban Level 1 trauma center in Atlanta, Georgia, to participate in an in-depth interview. Interviews were conducted between March 2019 and February 2020. Thematic analysis was used to identify a range of psychological effects from RBFs.
Interviews from 24 FRI survivors were analyzed: the majority of participants were Black males (N = 22, 92%) with a mean age of 32 years whose FRI occurred ∼8.6 months prior to data collection. The psychological effects of RBFs were grouped into four categories: physical health (eg, pain, limited mobility), emotional well-being (eg, anger, fear), social isolation, and occupational welfare (eg, disability leading to inability to work). A range of coping mechanisms were also identified.
Survivors of FRI with RBFs experience a range of psychological impacts that are far-reaching and affect daily activities, mobility, pain and emotional wellbeing. Study results indicate a need for enhanced resources to support those with RBFs. Further, changes to clinical protocols are warranted on removal of RBFs and communication about the effects of leaving RBFs in situ.
尽管与枪支有关的伤害（FRI）后存在大量遗留弹片（RBFs），但有关其全部后果的资料有限，尤其是对受伤者的心理影响。此外，现有的文献中还没有关于 RBF 受伤者的 FRI 幸存者的经历。本研究的目的是探讨 RBF 对最近经历过 FRI 的个体的心理影响。
从佐治亚州亚特兰大市的一家城市一级创伤中心有选择地招募了经影像学证实有 RBF 的 FRI 成年幸存者（18-65 岁）参加深入访谈。访谈于 2019 年 3 月至 2020 年 2 月进行。采用主题分析来确定 RBF 引起的一系列心理影响。
对 24 名 FRI 幸存者的访谈进行了分析：大多数参与者是黑人男性（N=22，92%），平均年龄为 32 岁，其 FRI 在数据收集前约 8.6 个月发生。RBF 的心理影响分为四类：身体健康（例如，疼痛，运动受限），情绪健康（例如，愤怒，恐惧），社会孤立和职业福利（例如，残疾导致无法工作）。还确定了一系列应对机制。
有 RBF 的 FRI 幸存者经历了一系列广泛的心理影响，这些影响会影响日常活动，活动能力，疼痛和情绪健康。研究结果表明，需要增强资源以支持有 RBF 的人。此外，需要更改临床方案，以去除 RBF，并就保留 RBF 原位的影响进行沟通。
