Neubert Anne, Hempe Sebastian, Jaekel Carina, Gaeth Catharina, Spering Christopher, Fetz Katharina, Windolf Joachim, Kollig Erwin, Bieler Dan
Department of Orthopedics and Traumatology, University Hospital and Medical, Faculty, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, Duesseldorf 40225, Germany.
Department of Orthopedics and Trauma Surgery, Reconstructive Surgery, Hand Surgery, Plastic Surgery and Burn Medicine, German Armed Forces Central Hospital, Rübenacher Str. 170, Koblenz 56072, Germany.
Injury. 2025 Jan;56(1):111938. doi: 10.1016/j.injury.2024.111938. Epub 2024 Oct 16.
Survivors of a major trauma experience a range of difficulties in relation to the reduction in physical, psychosocial, and cognitive functions, which can result in a reduced health-related quality of life. This study aims to explore lived experiences of major trauma survivors in the German healthcare system.
Semi-structured exploratory interviews were performed with nine major trauma survivors (18-55 years; Injury Severity Score ≥16). For exploratory analyses, an artificial intelligence-based coding software was used. Further, results were clustered by using the International Classification of Functioning, Disability and Health framework (ICF).
Communication was one of the major topics concerning amongst others diverting opinions between different healthcare disciplines and a general lack of information. The participants showed a high demand for a contact person. Furthermore, social support was essential during recovery for those interviewed. Social network was not only important as emotional and physical support but also for overcoming of gaps in the healthcare system. The support by employers and colleagues seemed to be beneficial for our participants in relation to returning to work. Further, psychological consequences of trauma, and that mobility is a key factor for quality of life, self-efficacy and return to work were discussed.
The qualitative analyses highlight several topics such as communication, burden of sickness, support systems that the participants mentioned as important along their journey through the German healthcare system during recovery. Through the ICF model the interplay of certain components that influenced the outcome of the major trauma survivors was visualized.
These results might offer a deepened understanding of modifiable components of a patient pathway in recovery process such as improvements of patient communication, provision of a contact person and others.
重大创伤幸存者在身体、心理社会和认知功能下降方面会经历一系列困难，这可能导致与健康相关的生活质量下降。本研究旨在探索德国医疗体系中重大创伤幸存者的生活经历。
对9名重大创伤幸存者（年龄18 - 55岁；损伤严重程度评分≥16）进行了半结构化探索性访谈。为进行探索性分析，使用了基于人工智能的编码软件。此外，结果依据国际功能、残疾和健康分类框架（ICF）进行了聚类。
沟通是主要话题之一，涉及不同医疗学科之间的意见分歧以及普遍存在的信息缺乏问题。参与者对联络人的需求很高。此外，社交支持对接受访谈者的康复至关重要。社交网络不仅作为情感和身体支持很重要，而且对于弥补医疗体系中的不足也很重要。雇主和同事的支持似乎对我们的参与者重返工作有益。此外，还讨论了创伤的心理后果，以及 mobility 是生活质量、自我效能感和重返工作的关键因素。
定性分析突出了几个主题，如沟通、疾病负担、支持系统，这些是参与者在德国医疗体系康复过程中提到的重要方面。通过ICF模型，影响重大创伤幸存者结果的某些组成部分之间的相互作用得以显现。
这些结果可能有助于更深入地理解康复过程中患者路径的可改变组成部分，如改善患者沟通、提供联络人等。
