Beliefs and expectations of rural hospital practitioners towards a developing trauma system: A qualitative case study

Adams, Ryan D.F.; Cole, Elaine; Brundage, Susan I.; Morrison, Zoë; Jansen, Jan O.

doi:10.1016/j.injury.2018.03.025

Cited by 8 publications

(13 citation statements)

References 27 publications

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“…Whilst there is a dearth of studies on the perspectives of rural clinicians on older adult trauma care, one study examined the views of rural clinicians on care of the general adult trauma population. This study also identi ed that the lack of support for rural clinicians was compounded by the lack of resources, putting extra pressure on healthcare staff (22). Participants in this study also identi ed the fragmentation of the healthcare system as a major barrier to providing trauma care (22).…”

Section: Discussionmentioning

confidence: 94%

“…This study also identi ed that the lack of support for rural clinicians was compounded by the lack of resources, putting extra pressure on healthcare staff (22). Participants in this study also identi ed the fragmentation of the healthcare system as a major barrier to providing trauma care (22).…”

Section: Discussionmentioning

confidence: 94%

“…Moreover, the evidence base for trauma care of older adults in rural areas is sparse, in part due to the lower volumes of patients and participants, and the lack of research opportunities (21). Although, our ndings are speci c to the local context of the study, they may prompt consideration of rural trauma care provision in countries with equivalent healthcare and trauma systems, such as North America and Scandinavia (22). There are also important limitations to consider in this study.…”

Section: Strengths and Limitationsmentioning

confidence: 88%

“…Thus, speci c and novel care models for managing older trauma that are adapted to the rural context are needed. Little is known about the experience and challenges faced by rural clinicians who manage trauma in older adults (22). An understanding of stakeholders' views is paramount to the effective development and implementation of a trauma system inclusive of rural communities.…”

Section: Introductionmentioning

confidence: 99%

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A descriptive qualitative study exploring clinicians’ perspectives of the management of older trauma care in rural Australia

Ferrah

Parker

Ibrahim

et al. 2022

Preprint

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Background For older trauma patients who sustain trauma in rural areas, the risk of adverse outcomes associated with advancing age, is compounded by the challenges encountered in rural healthcare such as geographic isolation, lack of resources, and accessibility. Little is known of the experience and challenges faced by rural clinicians who manage trauma in older adults. An understanding of stakeholders’ views is paramount to the effective development and implementation of a trauma system inclusive of rural communities. The aim of this descriptive qualitative study was to explore the perspectives of clinicians who provide care to older trauma patients in rural settings. Method We conducted semi-structured interviews of health professionals (medical doctors, nurses, paramedics, and allied health professionals) who provide care to older trauma patients in rural Queensland, Australia. A thematic analysis consisting of both inductive and deductive coding approaches, was used to identify and develop themes from interviews. Results Fifteen participants took part in the interviews. Three key themes were identified: enablers of trauma care, barriers, and changes to improve trauma care of older people. The resilience of rural residents, and breadth of experience of rural clinicians were strengths identified by participants. The perceived systemic lack of resources, both material and in the workforce, and fragmentation of the health system across the state were barriers to the provision of trauma care to older rural patients. Some changes proposed by participants included tailored education programs that would be taught in rural centres, a dedicated case coordinator for older trauma patients from rural areas, and a centralised system designed to streamline the management of older trauma patients coming from rural regions. Conclusions Rural clinicians are important stakeholders who should be included in discussions on adapting trauma guidelines in the rural setting. In this study, participants formulated pertinent and concrete recommendations that could improve trauma care in rural settings.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Section: Strengths and Limitationsmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A descriptive qualitative study exploring clinicians’ perspectives of the management of older trauma care in rural Australia

Ferrah

Parker

Ibrahim

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…The interview protocol was developed with a high focus on minimising any plausible wording (by being as neutral and open-ended as possible), habituation (by avoiding developing patterns of response), and acquiesce/social desirability (by masking any perceived interviewer preference) heuristics. [51][52][53][54] Interview procedures are provided in full in Appendix I. Intelligent transcription was conducted by two reviewers (MWS and MK) in Microsoft Word (Microsoft, 2022).…”

Section: Interview Proceduresmentioning

confidence: 99%

‘Send everyone, it’s my son’ – Combined Glaserian grounded theory and thematic analysis of paramedics attending their own families

Wilkinson-Stokes,

Kellermeier,

Whitfield

2023

Paramedicine

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Introduction Medical clinicians treating relatives is ethically complex; in paramedicine, the time-critical nature of pathologies often precludes alternative treatment without risking morbidity or mortality. Aims This project had three aims: firstly, to retrieve baseline data for thematic analysis on the experiences of paramedics who have attended their own families; secondly, to generate explanatory grounded theory; and finally, to translate these findings into recommendations for practice. Methods Glaserian grounded theory and thematic analysis methods were both undertaken using a realist perspective. Acquiescence, wording, and habituation heuristics were mitigated in the interview design. There were 44 responses ( n = 93 instances of treating family), with 21 participants ( n = 34) from three countries interviewed. Saturation was determined using both Guest et al.'s and Thorne's criterion. Semantic and latent themes were generated inductively via a five-step process, with grounded theory generated simultaneously via a three-step Glaserian process. Cohen's kappa ranged from 0.82 to 0.93. Results Incidents were both traumatic (hangings, stabbings, traumatic arrests) and medical (paediatric arrests, cardiac arrests, overdoses). The core concept-category was ‘conflict between the roles of clinician and relative’. Paramedics reported a sympathetic hyperarousal response that they quickly suppressed, a rapid transition into ‘work mode’, and difficulty obtaining their normal state of flow, balancing dual roles as clinician and relative, transitioning out of work mode and into becoming a carer, and simultaneously processing the event. Organisational responses were frequently described as inadequate. Paramedics reported short-term experiences consistent with an acute stress response, and a large proportion suffered long-term, life-altering consequences. It is theorised that this phenomenon disrupts professional detachment, increases outcome self-expectations, interrupts normal routines, and promotes overmedicalisation. Conclusion This research provides baseline data and theory on the experiences of paramedics attending their own families. Five themes and 24 subthemes were identified, an explanatory theorem proposed, and a preliminary set of eight recommendations for translation into practice provided. [Media: see text]

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Emergency trauma care in rural and remote settings: Challenges and patient outcomes

Morgan

Calleja

2020

International Emergency Nursing

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Beliefs and expectations of rural hospital practitioners towards a developing trauma system: A qualitative case study

Cited by 8 publications

References 27 publications

A descriptive qualitative study exploring clinicians’ perspectives of the management of older trauma care in rural Australia

A descriptive qualitative study exploring clinicians’ perspectives of the management of older trauma care in rural Australia

‘Send everyone, it’s my son’ – Combined Glaserian grounded theory and thematic analysis of paramedics attending their own families

Emergency trauma care in rural and remote settings: Challenges and patient outcomes

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