Injury perceptions and their association with recovery outcomes in adults with traumatic orthopaedic injuries: a scoping review

Abstract

Purpose

How people perceive their injury may be associated with recovery. This scoping review used the Common Sense Model of Illness Perceptions (CSM) as a framework to: (1) characterise injury perceptions; (2) describe biopsychosocial factors related to injury perceptions, and (3) determine how injury perceptions are associated with recovery outcomes.

Materials and methods

A broad search strategy was used across eight databases to identify studies exploring injury perceptions and related concepts in adults with traumatic orthopaedic injuries. Two reviewers independently screened and extracted data. Quality appraisal was performed using the Mixed Methods Appraisal Tool.

Results

The search yielded 9736 records, of which 22 publications were included; 12 quantitative and 10 qualitative studies. Overall, the quality of the evidence was low to moderate. Consistent with the CSM, injury perceptions comprised beliefs relating to the injury diagnosis, consequences, causes, recovery duration, and treatments. Perceptions of injury were multidimensional and influenced by personal, inter-personal, and socio-cultural factors. Negative injury perceptions were associated with worse functional outcomes.

Conclusions

Although this review provided some insight into the characteristics of injury perceptions, relationships between injury perceptions and recovery, and characteristics of perceptions across different socio-cultural or clinical settings are still poorly understood.

Implications for rehabilitation

• A person’s perception of their injury is complex; it emerges from dynamic interactions between personal, interpersonal and socio-cultural elements.

• People who perceive that their injury represents a threat to them typically report higher pain, negative affect, and worse general health than people with more positive perceptions of injury.

• Rehabilitation providers should consider how they might positively influence perceptions of traumatic orthopaedic injury.

• Perceptions of injury might be influenced at the individual level (e.g., during healthcare encounters), or at a system level, such as through endorsement of codes of practice for rehabilitation clinicians or funding of psychologically informed treatments to help people better understand their injuries.

Keywords:

• Injuries
• trauma
• rehabilitation
• chronic pain
• beliefs
• cognition

Acknowledgements

We greatly appreciated the assistance provided by University of Queensland liaison librarian, Jackie Devenish.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

PB was supported by an Australian Government Research Training Program Scholarship and Royal Brisbane and Women’s Hospital Foundation Post Graduate top-up scholarship. MJG was supported by funding from the Australian Research Council (DE170100726).