Patient and clinician perceptions of blunt chest trauma management and recovery: a qualitative study

Abstract

Purpose

To explore patient and clinician perceptions of blunt chest trauma management and recovery, when discharged directly home from the Emergency Department (ED).

Methods

This was a qualitative study, completed in a trauma unit in Wales. Blunt chest trauma was defined as an isolated blunt injury to the chest wall, resulting in bruising or rib fractures. Data collection involved semi-structured telephone interviews and focus groups with patients and clinicians respectively. Data analysis was completed using reflexive thematic coding.

Results

Twelve patient interviews and three focus groups (23 clinicians) were conducted. In the interviews, seven males and five females participated, with a mean age of 54 years (range 28–74). Clinicians included nurses, doctors, and therapists. Two main themes emerged; 1) the ED experience and 2) recovery once home; each with a number of sub-themes. Results highlighted the significant impact of pain on recovery, and that there is a disjuncture between organisational perspectives of clinicians, and the individual personal perspective of patients.

Discussion

Recovery from blunt chest trauma for patients discharged directly home from the ED is a challenging and complex process. Protocol-driven care does not always lead to good patient experience, as it focuses primarily on hospital services and resources.

IMPLICATIONS FOR REHABILITATION

• Recovery from blunt chest trauma is a complex process, leading to poor outcomes including pain and disability.

• Protocol-driven care of blunt chest trauma does not always lead to a good patient experience.

• Patients with blunt chest trauma benefit from reassurance that their severity of pain is normal, prior to discharge home from the Emergency Department (ED).

• Education regarding pacing activity, rest, and reliance on others for a period of time following injury can lead to an improved recovery experience.

Keywords:

• Blunt chest trauma
• patient perceptions
• clinician perceptions
• recovery
• management

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [CB], upon reasonable request.

Additional information

Funding

This work was supported by a Health and Care Research Wales Health Fellowship, on behalf of Welsh Government. Ref: HF-19-1587.