德国工作年龄段多发性创伤患者的生活经历--定性分析。

Anne Neubert, Sebastian Hempe, Carina Jaekel, Catharina Gaeth, Christopher Spering, Katharina Fetz, Joachim Windolf, Erwin Kollig, Dan Bieler
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摘要

背景:重大创伤幸存者在身体、社会心理和认知功能下降方面会遇到一系列困难,从而导致与健康相关的生活质量下降。本研究旨在探讨德国医疗系统中重大创伤幸存者的生活经历:方法:对九名重大创伤幸存者(18-55 岁;受伤严重程度评分≥16 分)进行了半结构式探索性访谈。在探索性分析中,使用了基于人工智能的编码软件。此外,还使用国际功能、残疾和健康分类框架(ICF)对结果进行了分组:结果:交流是主要议题之一,涉及不同医疗学科之间的意见分歧和信息的普遍缺乏。参与者对联系人的需求很高。此外,社会支持对受访者的康复至关重要。社会网络不仅是情感和身体上的支持,而且对于克服医疗系统的不足也很重要。雇主和同事的支持似乎对受访者重返工作岗位很有帮助。此外,我们还讨论了创伤的心理后果,以及流动性是生活质量、自我效能感和重返工作岗位的关键因素:定性分析突出了几个主题,如沟通、疾病负担、支持系统,这些都是参与者在康复过程中通过德国医疗系统所提到的重要问题。通过 ICF 模型,可以直观地看出影响重大创伤幸存者康复结果的某些因素之间的相互作用:这些结果可能会加深人们对患者康复过程中可改变的因素的理解,如改善患者沟通、提供联系人等。
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Lived experiences of working-age polytrauma patients in Germany - A qualitative Analysis.

Background: Survivors of a major trauma experience a range of difficulties in relation to the reduction in physical, psychosocial, and cognitive functions, which can result in a reduced health-related quality of life. This study aims to explore lived experiences of major trauma survivors in the German healthcare system.

Methods: Semi-structured exploratory interviews were performed with nine major trauma survivors (18-55 years; Injury Severity Score ≥16). For exploratory analyses, an artificial intelligence-based coding software was used. Further, results were clustered by using the International Classification of Functioning, Disability and Health framework (ICF).

Results: Communication was one of the major topics concerning amongst others diverting opinions between different healthcare disciplines and a general lack of information. The participants showed a high demand for a contact person. Furthermore, social support was essential during recovery for those interviewed. Social network was not only important as emotional and physical support but also for overcoming of gaps in the healthcare system. The support by employers and colleagues seemed to be beneficial for our participants in relation to returning to work. Further, psychological consequences of trauma, and that mobility is a key factor for quality of life, self-efficacy and return to work were discussed.

Discussion: The qualitative analyses highlight several topics such as communication, burden of sickness, support systems that the participants mentioned as important along their journey through the German healthcare system during recovery. Through the ICF model the interplay of certain components that influenced the outcome of the major trauma survivors was visualized.

Implications: These results might offer a deepened understanding of modifiable components of a patient pathway in recovery process such as improvements of patient communication, provision of a contact person and others.

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