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|Title: ||Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care|
|Authors: ||Christie, Nicola|
|Keywords: ||General practitioners|
Primary health care
|Issue Date: ||2016|
|Publisher: ||© Royal College of General Practioners|
|Citation: ||CHRISTIE, N. ...et al.,2016. Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care. British Journal of General Practice, 66(642), pp. E24-E31.|
In the UK, studies suggest that the transition from hospital to home after an injury can be a difficult time and many patients report feeling inadequately prepared. Patients often use primary care services after hospital discharge. These consultations provide opportunities to
consider problems that patients experience and to facilitate recovery. Little is known, however, about how patients and service providers view care after hospital discharge and the role played by primary care services, specifically GPs.
To identify good practice and unmet needs in
respect of post-discharge support for injured
Design and setting
Qualitative study using semi-structured
interviews at four sites (Bristol, Leicester/
Loughborough, Nottingham, and Surrey).
Qualitative interviews with 40 service providers and 45 hospitalised injured patients.
Although there were examples of wellmanaged
hospital discharges, many patients felt they were not provided with the information they needed about their injury, what to expect in
terms of recovery, pain control, return to work, psychological problems, and services to help meet their needs. They also described difficulty accessing services such as physiotherapy or counselling. Service providers identified problems with communication between secondary and primary care, lack of access to physiotherapy, poor communication about other services that may help patients, GP service and resource constraints, and difficulties in providing information to patients concerning likely prognosis.
Discharge from hospital after an injury can
be problematic for patients. Changes in both
secondary and primary care are required to
resolve this problem.|
|Description: ||This paper was accepted for publication in the journal Journal of General Practice and is available at http://dx.doi.org/10.3399/bjgp15X688141.|
|Sponsor: ||distinguish between early psychological
responses to injury, which they regard as
‘normal’ or ‘to be expected’, and persistent
or severe symptoms regarded as illness.
They respond to early symptoms with
reassurance and support, or in some cases
with advice on gradually reintroducing feared
activities. Patients report GPs’ reluctance,
however, to refer for counselling or other
psychological support. Providing normalising
information about the usual reactions to
trauma, discussing the likely trajectory of
symptoms, offering coping suggestions,
encouraging social support (for example,
self-help groups), and use of other sources
of support (for example, self-help literature,
online resources, charities) can help patients
cope after injuries. Reassuring patients
about ongoing support and discussing
availability of psychological services, waiting
times, and referral if symptoms are not
resolving, may help patients to feel that their
psychological needs are being considered.
Research is required to evaluate the impact
of these measures on patient-reported
outcomes including satisfaction with care
and measures of recovery.
The project was funded by the National
Institute for Health Research funding
scheme for the Collaboration for
Leadership in Applied Health Research
and Care Nottinghamshire, Derbyshire and
Lincolnshire, and now East Midlands.|
|Publisher Link: ||http://dx.doi.org/10.3399/bjgp15X688141|
|Appears in Collections:||Published Articles (Design School)|
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