Identifying Challenges of Providing Care for Trauma Patients; A Concurrent Mixed Methods Study

Document Type : Original Article

Authors

1 Department of Nursing Education, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 Department of Nursing, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of medical sciences, Shiraz- Iran

3 Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden

Abstract

Background: Caregiving for trauma patients has many challenges. Inadequate knowledge of these challenges can affect the patients and worsen their conditions.
Objectives: We aimed to explore the caregivers’ experiences about these challenges and problems of caring for patients with trauma emergencies.
Methods: The study adopted a concurrent triangulation mixed-method and was conducted in Shahid Rajaee Hospital, southern Iran, in 2019. Semi-structured interviews, focus groups, observation and ward document assessments were conducted with focusing on the challenges experienced by the caregivers. A checklist was used to assess the performance of caregivers and measure the indices related to the care process. Statistical results and qualitative data on the main categories were compared and integrated for data analysis.
Results: In total,307 codes were extracted by analyzing the content of the interviews and available evidence. The codes were summarized in 20 subcategories, and six main categories were extracted as follows: lack of professional capability, uncoordinated team response, deficits in managerial commitments, inadequate work motivation, complex nature of trauma emergency, and lack of clinical communication. The quantitative results indicated that caregivers’ performance was considerably far from the expected scores and also many indices indicated a waste of time in responding to the patient needs.
Conclusion: Various dimensions of trauma care challenges indicate that professional capability, team coordination and communication, managerial commitments and work motivation considering the complex nature of trauma emergency wards are crucial to enhance patients' access to optimum quality care. Caregivers’ performance and quality of indices also affect the care process. Future studies are required for compiling strategies and protocols for the quality of care for trauma patients.

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