Traumatic injury survivors’ perceptions of their future: a longitudinal qualitative study

Abstract

Aim: Persistent disability following traumatic injuries can disrupt future plans and create uncertainty about how to mitigate future impacts. It is unknown how or whether perceptions of the future change in the years after injury. Therefore, the aim of this study was to explore trauma survivors’ perceptions of their future over time.

Methods: A longitudinal qualitative study, nested within a population-based longitudinal cohort study, was undertaken in Victoria, Australia with survivors of serious injury. Sixty-six seriously injured adults (≥16 years) without severe neurotrauma were interviewed at 3 years post-injury (n = 66), and re-interviewed at 4 (n = 63) and 5 years (n = 57) post-injury. A longitudinal thematic analysis was performed.

Results: Many traumatically injured people had persistent physical and mental impacts. Participants reported being anxious about pain, mobility, work, housing and accommodation, social activities, and finances in their future. Others were hopeful and optimistic regarding their future and developed coping strategies and adopted new viewpoints.

Conclusion: Over time, most seriously injured people’s perceptions of the future remained consistent. Some had enduring anxiety and others sustained hopeful approaches. Personalised and targeted interventions that address specific concerns could reduce anxiety and support positive adjustment following traumatic injury.

Implications for rehabilitation

• Many seriously injured people, particularly people who sustained orthopaedic injuries, held concerns about experiencing persistent pain, physical impairment, and reduced mobility in the future.

• Personalised and targeted interventions that address specific concerns about future financial, social, housing and employment issues could reduce anxiety and support coping and adjustment strategies.

• In addition to their direct impacts on post-injury recovery, health, rehabilitation, occupational, social, and insurance systems all have a role in facilitating positive responses of injury survivors that draw on their strengths and sources of resilience.

Keywords:

• Trauma
• injury
• interviews
• disability
• ageing
• future expectations
• qualitative

Acknowledgements

We would like to thank the investigators, Steering Committees and the participating hospitals of the VSTR and to express our appreciation to the participants. We would also like to thank Mandy Brown and Dan Myles for their assistance with the interviews.

Disclosure statement

The RESTORE project was funded by National Health and Medical Research Council (NHMRC) of Australia [GNT1061786]. The Victorian State Trauma Registry is funded by the Transport Accident Commission and the Department of Health and Human Services. Belinda Gabbe was supported by a Future Fellowship from the Australian Research Council, Peter Cameron by a NHMRC Practitioner Fellowship, and Christina Ekegren by a NHMRC Early Career Fellowship. The other authors report no conflict of interest.