Psychological and psychosocial aspects of major trauma care in the United Kingdom: A scoping review of primary research

Abstract

Introduction More people are surviving major trauma, often with life changing injuries. Alongside physical injury, many survivors of major trauma experience psychological and psychosocial impacts. Presently, there is little guidance at the UK national level for psychological and psychosocial aspects of major trauma care. Set in the context of the regional model of major trauma care implemented in the UK in 2012, the purpose of this review was to identify and bring together primary research about psychological and psychosocial aspects of major trauma care in the UK to produce an overview of the field to date, identify knowledge gaps and set research priorities. Methods A scoping review was undertaken. Seven electronic databases (MEDLINE, Cochrane Library, CINAHL, Embase, PsycINFO, SocINDEX with Full Text and PROSPERO) were searched alongside a targeted grey literature search. Data from included studies were extracted using a predefined extraction form and underwent bibliometric analysis. Included studies were then grouped by type of research, summarised, and synthesised to produce a descriptive summary and overview of the field. Results The searches identified 5,975 articles. Following screening, 43 primary research studies were included in the scoping review. The scoping review, along with previous research, illustrates that psychological and psychosocial impacts are to be expected following major trauma. However, it also found that these aspects of care are commonly underserved and that there are inherent inequities across major trauma care pathways in the UK. Conclusion Though the scoping review identified a growing body of research investigating psychological and psychosocial aspects of major trauma care pathways in the UK, significant gaps in the evidence base remain. Research is needed to establish clinically effective psychological and psychosocial assessment tools, corresponding interventions, and patient-centred outcome measures so that survivors of major trauma (and family members or carers) receive the most appropriate care and intervention.

Patient perspectives of recovery following major musculoskeletal trauma: A systematic review and qualitative synthesis

“…Qualitative studies focusing on patient perspectives of recovery following isolated SCI or TBI were also excluded as these patients tend to have a vastly different clinical care pathway and recovery trajectory. 20…”

“…[8][9][10] However, little is known about longer-term functional outcomes or how patients experience recovery, limiting our ability to develop the best pathways or services for patients and evaluate the effectiveness of rehabilitation interventions. [11][12][13] Primary research studies have started to investigate the long-term psychosocial impacts of major trauma, [8][9][10] and previous studies have identified persistent pain, poor rates of return to work, and psychological manifestations such as anxiety as indicators of poor recovery. [14][15][16][17] However, patient's lived experience of traumatic injury remains unquantified and poorly understood by rehabilitation specialists and researchers.…”

“…Patients with major musculoskeletal trauma (MMSKT) may have vastly different recovery trajectories to those with isolated traumatic brain injury (TBI) or spinal cord injury (SCI) traditionally associated with complex rehabilitation needs and long-term complications, and recent research has acknowledged that MMSKT also causes long-term adverse effects on health, work, social participation and quality of life. 20 Therefore, there is a need for further research to understand the experiences of rehabilitation and recovery in people with non-neurological major trauma. Qualitative research has conceptualised the patient experience following MMSKT as a journey through repair and rehabilitation to achieve recovery.…”

Psychological and psychosocial aspects of major trauma care: A survey of current practice across UK and Ireland

“…Although major trauma policy documents across the UK and Ireland (ibid) incorporate psychological and psychosocial aspects of care, the level of detail across them varies. There is evidence that these aspects of major trauma care are often underserved in the UK 23 . Although major trauma networks may operate differently, the aim of this research was to gain insight into current provision and operationalisation of psychological and psychosocial aspects of major trauma care for survivors and their families across the UK and Ireland.…”

“…There is evidence that these aspects of major trauma care are often underserved in the UK. 23 Although major trauma networks may operate differently, the aim of this research was to gain insight into the current provision and operationalisation of psychological and psychosocial aspects of major trauma care for survivors and their families across the UK and Ireland.…”