Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
J Surg Res. 2023 Nov;291:303-312. doi: 10.1016/j.jss.2023.06.020. Epub 2023 Jul 26.
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.
创伤会将一个健康、独立的个体变成一个需要复杂医疗的患者。人们对受伤患者在急性后恢复期如何理解自己的健康和医疗需求知之甚少，这限制了我们优化护理的能力。这项多方法研究探讨了受伤患者在出院后 30 天内的护理体验。
2019 年 8 月 1 日至 2020 年 11 月 30 日，有目的地对入住城市一级创伤中心的成年受伤患者进行抽样，以平衡钝器伤和穿透伤。使用创伤护理质量患者报告体验量表，在基线和出院后 30 天评估患者的体验和健康状况。对一个有目的的亚组进行了 15 次定性访谈，并使用定性内容分析进行了分析。
在 67 名参与者（76%为男性，73%为黑人，51%为穿透伤，中位年龄 34 岁）中，有 37 名完成了随访调查。81%的样本对急性护理的质量评分为 9-10/10，而对急性护理的评分仅为 65%（P=0.09）。30%的人描述自己的心理健康状况一般或较差，但只有 2/3 的人得到了心理健康方面的关注。31%的人在基线时有疼痛控制不足的情况，而在随访时有 46%（P=0.09）的人有疼痛控制不足的情况。定性分析显示，患者对急性护理体验的质量表示满意，但在康复过程中，存在沟通和护理协调方面的需求未得到满足。
创伤患者对他们的急性护理体验质量表示赞赏，但也指出了在预后沟通、疼痛管理和心理健康支持方面需要改进的地方。在出院后至少 1 个月，患者仍存在未得到满足的身心护理需求，这强化了需要采取干预措施来优化急性后创伤护理的必要性。
