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Provider perspectives on rehabilitation of patients with polytrauma.
Arch Phys Med Rehabil. 2008 Jan; 89(1):171-8.AP

Abstract

OBJECTIVES

To describe, from the perspective of U.S. Department of Veterans Affairs (VA) polytrauma rehabilitation providers, (1) patients with combat-related polytrauma and their rehabilitation, (2) polytrauma patient family member involvement in rehabilitation, and (3) the impact on providers of providing polytrauma rehabilitation.

DESIGN

Qualitative study based on rapid assessment process methodology, which included semistructured interviews, observation, and use of a field liaison.

SETTING

The 4 VA polytrauma rehabilitation centers (PRCs).

PARTICIPANTS

Fifty-six purposefully selected PRC providers and providers from consulting services.

INTERVENTIONS

Not applicable.

MAIN OUTCOMES MEASURES

Provider self-report of polytrauma patient characteristics, polytrauma patient family member involvement in rehabilitation, and the impact of polytrauma rehabilitation on providers themselves.

RESULTS

According to PRC providers, polytrauma patients are younger than VA rehabilitation patients. Strong military identities affect rehabilitation needs and reactions to severe injury. The public and the media have particular interest in war-injured patients. Patients with blast-related polytrauma have unique constellations of visible (including amputations, craniectomies, and burns) and invisible (including traumatic brain injury, pain, and posttraumatic stress disorder) injuries. Providers have adjusted treatment strategies and involved services outside of rehabilitation because of this clinical complexity. Family members are intensely involved in rehabilitation and have service needs that may surpass those of families of rehabilitation patients without polytrauma. Sources of provider stress include new responsibilities, media attention, increased oversight, and emotional costs associated with treating severely injured young patients and their families. Providers also described the work as deeply rewarding.

CONCLUSIONS

The VA should prioritize the identification or development and implementation of strategies to address family member needs and to monitor and ensure that PRC providers have access to appropriate resources. Future research should determine whether findings generalize to patients injured in other wars and to people who sustain polytraumatic injuries outside of a war zone, including victims of terrorist attacks.

Authors+Show Affiliations

Center for Chronic Disease Outcomes Research VA Medical Center, Minneapolis, MN, USA. frie0013@umn.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

18164350

Citation

Friedemann-Sánchez, Greta, et al. "Provider Perspectives On Rehabilitation of Patients With Polytrauma." Archives of Physical Medicine and Rehabilitation, vol. 89, no. 1, 2008, pp. 171-8.
Friedemann-Sánchez G, Sayer NA, Pickett T. Provider perspectives on rehabilitation of patients with polytrauma. Arch Phys Med Rehabil. 2008;89(1):171-8.
Friedemann-Sánchez, G., Sayer, N. A., & Pickett, T. (2008). Provider perspectives on rehabilitation of patients with polytrauma. Archives of Physical Medicine and Rehabilitation, 89(1), 171-8. https://doi.org/10.1016/j.apmr.2007.10.017
Friedemann-Sánchez G, Sayer NA, Pickett T. Provider Perspectives On Rehabilitation of Patients With Polytrauma. Arch Phys Med Rehabil. 2008;89(1):171-8. PubMed PMID: 18164350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Provider perspectives on rehabilitation of patients with polytrauma. AU - Friedemann-Sánchez,Greta, AU - Sayer,Nina A, AU - Pickett,Treven, PY - 2007/06/21/received PY - 2007/10/16/revised PY - 2007/10/18/accepted PY - 2008/1/1/pubmed PY - 2008/2/5/medline PY - 2008/1/1/entrez SP - 171 EP - 8 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 89 IS - 1 N2 - OBJECTIVES: To describe, from the perspective of U.S. Department of Veterans Affairs (VA) polytrauma rehabilitation providers, (1) patients with combat-related polytrauma and their rehabilitation, (2) polytrauma patient family member involvement in rehabilitation, and (3) the impact on providers of providing polytrauma rehabilitation. DESIGN: Qualitative study based on rapid assessment process methodology, which included semistructured interviews, observation, and use of a field liaison. SETTING: The 4 VA polytrauma rehabilitation centers (PRCs). PARTICIPANTS: Fifty-six purposefully selected PRC providers and providers from consulting services. INTERVENTIONS: Not applicable. MAIN OUTCOMES MEASURES: Provider self-report of polytrauma patient characteristics, polytrauma patient family member involvement in rehabilitation, and the impact of polytrauma rehabilitation on providers themselves. RESULTS: According to PRC providers, polytrauma patients are younger than VA rehabilitation patients. Strong military identities affect rehabilitation needs and reactions to severe injury. The public and the media have particular interest in war-injured patients. Patients with blast-related polytrauma have unique constellations of visible (including amputations, craniectomies, and burns) and invisible (including traumatic brain injury, pain, and posttraumatic stress disorder) injuries. Providers have adjusted treatment strategies and involved services outside of rehabilitation because of this clinical complexity. Family members are intensely involved in rehabilitation and have service needs that may surpass those of families of rehabilitation patients without polytrauma. Sources of provider stress include new responsibilities, media attention, increased oversight, and emotional costs associated with treating severely injured young patients and their families. Providers also described the work as deeply rewarding. CONCLUSIONS: The VA should prioritize the identification or development and implementation of strategies to address family member needs and to monitor and ensure that PRC providers have access to appropriate resources. Future research should determine whether findings generalize to patients injured in other wars and to people who sustain polytraumatic injuries outside of a war zone, including victims of terrorist attacks. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/18164350/Provider_perspectives_on_rehabilitation_of_patients_with_polytrauma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(07)01743-1 DB - PRIME DP - Unbound Medicine ER -