System complexities affecting recovery after a minor transport-related injury: The need for a person-centred approach

Abstract

Injuries from transport accidents are heterogeneous and recovery processes complex and challenging for people, regardless of the severity of injury sustained. Multiple factors influence the recovery trajectory, including pain, poor pre-accident health state, psychological comorbidities, socioeconomic disadvantage and, in some instances, financial compensation. In particular, the results on the effect of financial compensation on health outcomes following musculoskeletal injury remain controversial, indicating that further research is needed to understand the possible barriers and complexities involved in compensation processes and service delivery. This qualitative study investigated compensation-related barriers and found that recovery is indeed impacted by numerous challenges in using compensation services after traffic accident. To overcome these issues, it is recommended that a person-centred approach is used as foundation to inform decision-making for interventions aimed at improving recovery outcomes. An improved recovery management, communication and adequate provision of guidelines is needed and highly recommended to meet clients' needs and facilitate better outcomes. Objective: To understand clients' experiences of the recovery journey through the compensation system and to identify areas and strategies for quality improvement. Methods: A qualitative study of 23 participants with physical or mental disabilities caused by traffic accidents, which occurred, on average, 4 years ago. Purposive sampling of long-term recovery clients who made a compensation claim after their injuries was applied until data saturation was reached. Data were collected using semi-structured interviews and analysed through conventional thematic analysis. Results: This study demonstrated that recovery is a complex phenomenon that can be impacted by numerous challenges of navigating the compensation system and using its services. Clients perceived the compensation provider as limited in rules around which services they could access. A common perception amongst clients was that the compensation provider did not have the capacity and knowledge to understand health and recovery processes nor did it provide adequate guidelines or instructions that would assist clients with their recovery. Many clients dealt with numerous case managers and felt insufficiently informed on what to expect and do, which led to a lack of trust in rehabilitation management and case managers' decisions. According to clients, financial impacts were neglected and not addressed effectively. Many clients felt abandoned by the system which led to perceived feelings of desertion and negligence. Conclusion: Understanding modifiable barriers to recovery in compensation systems presents opportunities to amend current practices and consider a holistic, person-centred care approach. It is apparent that improved recovery management, communication and adequate provision of guidelines are needed to meet clients' needs and facilitate better outcomes. A person-centred care app...

Biopsychosocial factors associated with poor health-related quality of life after minor to moderate transport-related injuries: Insights into the Victorian compensable population

“…We do not know if our results would be applicable to a wider non-compensable injured population or to patients managed by other compensation agencies, hence caution is advised when generalizing these findings. Thirdly, this study is limited to the analysis of the association between variables available in the current survey, and many other factors identified through previous qualitative study were not tested (32). Finally, the EQ-5D-3L was the only validated instrument in this study.…”

“…A recent systematic review (15) and qualitative study (16) provided the basis for selecting risk factors associated with poor recovery, to be tested in this study. The qualitative study sampled people contributing to the TAC COS, also used in this study.…”

“…Characteristics of the cohort are described in Table III. A total of 1,574 survey participants were included in the analyses, with a mean EQ-5D-3L health summary score of 0.71 (SD 0.25). More than half (56%) were male and 63% were in young (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) to middle-aged (35-54) age groups. More than one third of participants were in a relationship that involved children (37%) with secondary (44%) or tertiary undergraduate (41%) education level.…”

Implicações biopsicossociais em vítimas de acidente de trânsito que cursaram com deficiência adquirida

“…É notório que o acidente é visto como um evento inesperado, em que as pessoas não acreditam que possam acontecer consigo ou com pessoas próximas. A ideia prevalente, semelhante a outros achados, é que se trata de um evento distante, o que faz com que a segurança seja colocada em segundo plano 24 .…”

Effects of seeking compensation on the psychological health and recovery of injured patients: the role of stress vulnerability and injury-related disability

“…Psychological health appears to be the most adversely affected (Collie, 2018; Elbers et al, 2013; Murgatroyd et al, 2015b; Murgatroyd, Harris, Tran, & Cameron, 2016), as shown in a meta-analysis of 29 studies (Murgatroyd et al, 2015b), resulting in serious clinical and financial concern as psychological distress means delayed recovery and higher costs (Gopinath et al, 2019; Guest, Tran, Gopinath, Cameron, & Craig, 2017; Kenardy, Heron-Delaney, Warren, & Brown, 2015). Some have argued that secondary gain such as financial incentives (Cameron et al, 2008; Cassidy et al, 2000; Elbers et al, 2013; Hadler, 1996; Harris et al, 2005), or stressful claim processes or secondary victimization (Elbers et al, 2013; Grant et al, 2014; O'Donnell et al, 2015; Samoborec, Ayton, Ruseckaite, Winbolt, & Evans, 2019; Thompson, Elbers, Cameron, Craig, & Guest, 2018) may be responsible for poor outcomes among those seeking compensation. Nonetheless, the commonly held view that compensation is more harmful than helpful to health when engaged in compensation continues to have profound implications in terms of barriers to healthcare and stigmatization of compensation seekers (Grant & Studdert, 2009; Varker, Creamer, Khatri, Fredrickson, & O’Donnell, 2018).…”