Perceived Changes in Quality of Life in Trauma Patients: A Focus Group Study

Abstract

Quality of life (QoL) following a physical trauma is still insufficiently known from a patient perspective. The aim of this study was to qualitatively report perceived changes in QoL after trauma. Focus groups were conducted. Patients admitted to the hospital were eligible for inclusion if they had a lower extremity trauma, severe injuries, or severe traumatic brain injury (TBI). Patients 75 years or older were invited. To analyze the perceived changes in QoL, open coding was used. Patients (n = 20, M = 55 years) reported comparable consequences. In the first month posttrauma, physical limitations, independency, pain, and anxiety predominated. Later, patients experienced problems with acceptance. The patients' feelings of the need to have control over their own situation, their own expectations, and a social network were related to QoL. Compared with the other patient groups, TBI patients reported more psychosocial consequences, and elderly patients reported more difficulties in performing (social) activities. Quality of health care was considered an important aspect in the patients' perceived QoL, and adequate aftercare was missed according to the patients. The impact of a trauma influences QoL in different health domains. Further improving the quality of aftercare may positively influence trauma patients' perceived QoL. These results indicated that TBI patients and elderly patients deserve specific attention regarding QoL.

A meta-synthesis of individual, interpersonal, and systemic factors impacting resilience after traumatic brain injury.

“…Individuals with TBI also utilized psychological coping strategies that helped them manage emotional distress and promote balanced thinking. These strategies included adopting a present moment focus and cultivating mindful awareness of daily activities (Douglas, 2013; Kruithof et al, 2018), as well as a number of strategies to promote positive mood (e.g., cultivating gratitude and optimism) (Mumbower et al, 2019; Nalder et al, 2013) and a positive framing of their current challenges and identity (e.g., focusing on values, cultivating acceptance, adopting a growth mindset) (McPherson et al, 2018; Salas et al, 2018). For example, participants described viewing the TBI as a “new beginning” linked to a renewed desire to pursue goals as well as a chance to modify their health behaviors (e.g., sleep, exercise, substance use) to optimize recovery.…”

Prediction of recovery in trauma patients using Latent Markov models

“…Previous studies suggest that patients' coping abilities and recovery expectations will influence their prognosis [11,15,38]. Busse et al [38] showed that a worse coping and pessimism regarding recovery 6 weeks after surgical repair of open extremity fractures was predictive to persistent pain, reduced quality of life, and pain interference after 1 year.…”

“…Previous studies showed that individual recovery expectations influenced the recovery after trauma or orthopedic surgery [11,12]. Patients with higher baseline expectations for a total hip or knee replacement showed greater improvements in 1 year [12,13].…”

Effectiveness and cost‐effectiveness of the Transmural Trauma Care Model investigated in a multicenter trial with a controlled before‐and‐after design: A study protocol

“…In older age groups, it is one of the most important causes of death, behind cardiovascular disease and cancer (GBD 2017 Mortality Collaborators, 2018; Nickson, 2015). In addition, trauma negatively influences a patient's physical functioning and health‐related quality of life (HR‐QOL; Kendrick et al., 2011; Kruithof et al., 2018; van der Sluis, Eisma, Groothoff, & ten Duis, 1998; Stalp et al., 2002). Since trauma patients are typically relatively young, the associated loss of disability‐adjusted life years (DALYs) is higher than in any other disease (Murray et al., 2012).…”