Psychosocial care for road traffic injury patients: An exlporation of service provision to patients attending orthopaedic clinic at Queen Elizabeth Central Hospital in Blantyre
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Date
2020-06-05
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Kamuzu University of Health Sciences
Abstract
This is a qualitative study employing a phenomenological design as it examines human experience
through the descriptions that are provided by the participants.
Annually, an estimated 1.2.million people worldwide are killed in road crashes and as many as 50
million are injured, occupying 30 to 70 percent of orthopedic beds in developing countries’
hospitals. In 2013, over 85% of all deaths and 90% of disability adjusted life years lost from road
traffic injuries occurred in low and middle-income countries which have only 47% of the world’s
registered vehicles.
Biopsychosocial models where psychosocial factors are assessed and treated along with medical
care have become standard of care in the treatment of many medical conditions including cancer
but have not been incorporated in most orthopaedic practices. This happens because the health
workers do not have time to probe more on psychosocial issues and others feel that the patients
will feel stigmatized if asked this.
Kohler et al did a research on quality of life after lower extremity trauma which was conducted at
Kamuzu Central Hospital in Lilongwe and found that apart from having physical disabilities, work
performance, school performance and overall quality of life is affected, but he did not look at
factors that prevent health workers from providing the psychosocial care to these patients.
Apart from determining mechanism of injury, assessment of patient’s social and professional status
to identify potential problems that might affect treatment and rehabilitation, is also necessary.
Many studies have shown that there is association between orthopaedic injuries which are
secondary to road traffic accidents and psychosocial breakdown but in Malawi, especially at Queen
Elizabeth’s Central Hospital no known study has explored the barriers of psychosocial care to
these patients.
This study sets to examine barriers and enablers in providing effective psychosocial care in road
traffic injury patients. It will specifically establish the provision of psychosocial services to
patients with road traffic injuries and examine influence of health workers in ensuring provision
of psychosocial care to orthopaedic patients involved in road traffic injuries. The study is also
exploring lived experiences of orthopaedic patients involved in road traffic accidents and to
identify psychosocial factors that hinder holistic recovery of orthopaedic patients involved in road
traffic injuries.
The study sample is 20 people, which will include orthopaedic patients attending specialist clinic
at Queen Elizabeth Hospital. Participants will be those aged 18 and above, had limb fractures due
to road traffic accidents within a period of one year, were admitted and are now attending followup
clinic. Guardians and health personnel will also be included. Exclusion criteria will include all
patients who had limb fractures but were not admitted, those with other limb pathologies attending
this clinic will also be excluded. Patients below 18 years will also be excluded.
Purposive type of sampling will be used because the study participants are representative of the
study phenomenon and are knowledgeable about the question at hand. An interview guide will be
used for all the objectives. Ethical approval to conduct the study will be sought from COMREC
and will get permission to conduct the study from the Hospital Director of Queen Elizabeth Central
Hospital. Patients, guardians and nurses will provide an informed consent before engaging them
on this study. Each respondent will be identified by a number which will be unique for anonymity.
Data will be audio recorded, and then transcribed verbatim. Data analysis will proceed through
coding and generating themes. This will be done using N vivo application. This software will help
to handle and manage the data.
Work overload, inadequate knowledge and lack of interest in health personnel are some of the
expected findings and these can be addressed by having consultative meetings.