Abstract
ObjectiveTo explore information needs of unintentional injury patients and their carers over time, across services, and how such needs are met from the perspectives of patients, carers and service providers. MethodsQualitative nested study within a multi-centre longitudinal study quantifying psycho-social, physical, occupational outcomes and service use and costs following a range of unintentional injuries. Semi-structured interviews conducted with 45 patients during the first year post injury, 18 of their carers and 40 providers of services. ResultsPatients and carers needed information about the nature and severity of injury, prognosis, self-management and further services. Information needs changed over time with the biggest difficulties being during transfer from primary to secondary care. Barriers to information provision included service providers’ time limitations and uncertainty around information provision, and patients’ reluctance to ask for information or inability to process it. Suggested improvements included provision of reassurance as well as factual information, information about further services, earlier follow-up, increased appointment times and greater involvement of families where appropriate. ConclusionsThe information needs of patients and carers post injury change with time and there are a number of ways to remove gaps and barriers in current provision to meet such needs. Practice implicationsProviding information on injury management, prognosis and available services and reassurance at each stage of the recovery process in secondary care and when transferring to primary care would be helpful for patients and carers. A follow-up contact soon after discharge and the opportunity to ask questions could be beneficial. Better information about the patient's needs and ways they can help could help carers fulfil their caring role.
Highlights
Unintended injuries are a leading cause of disability worldwide [1] with wide ranging social, psychological, physical and economic consequences for patient, family, health services and society [2,3,4]
Semi structured interviews were conducted with a subset of injured patients (n=45) with lower or upper limb or multiple injuries, their carers (n=18), and providers of services used by patients (n=40)
In addition to the medical explanations routinely provided by health professionals, patients and carers sought: guidance about the extent of physical exertion permissible or required; information about the significance of symptoms and guidance on when to seek medical advice; reassurance about what was „normal‟ following their type of injury and prediction of timescales for and extent of recovery
Summary
Unintended injuries are a leading cause of disability worldwide [1] with wide ranging social, psychological, physical and economic consequences for patient, family, health services and society [2,3,4]. Post-injury information needs and provision are poorly understood. The importance of information in increasing patient engagement in care and adherence to treatment is well established [5], as is the significance of family engagement in enhancing recovery [6, 7]. Studies demonstrate how lack of information inhibits patient involvement in treatment [8] and causes communication breakdown [9]. Barriers to effective patient-practitioner communication include conflicting information, lack of mutual understanding, mismatch between needs and provision, lack of aftercare and treatment information [10,11,12,13,14]
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