Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Leiv Arne Rosseland¹  Jeanette Finstad¹  Olav Røise²  Ingrid Amalia Havnes³  Thomas Clausen⁴ 

[1] Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Postbox 4956, 0424, Nydalen, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Norwegian Trauma Registry, Division of Orthopedic Surgery, Oslo University Hospital, Postbox 4956, 0424, Nydalen, Oslo, Norway;National Advisory Unit On Substance Use Disorder Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, 0424, Nydalen, Oslo, Norway;Norwegian Centre for Addiction Research, University of Oslo, Postbox 1039, 0315, Blindern, Oslo, Norway;

关键词: Traumatic injury;    Post-discharge care;    Outcomes;    Pain management;    Mental health;    Opioids;    Qualitative;    Interviews;   

DOI  :  10.1186/s13049-021-00938-7

来源: Springer

【 摘 要 】

BackgroundPhysical trauma is associated with mortality, long-term pain and morbidity. Effective pain management is fundamental in trauma care and opioids are indispensable for treating acute pain; however, the use and misuse of prescribed opioids is an escalating problem. Despite this, few studies have been directed towards trauma patients in an early phase of rehabilitation with focusing on experiences and perspectives of health and recovery including pain and persistent use of prescribed opioids with abuse potential. To explore pre- and post-discharge trauma care experiences, including exposure to opioids, physical trauma survivors were recruited from a major trauma centre in Norway that provides the highest level of surgical trauma care.MethodQualitative exploratory study. Individual semi-structured interviews were conducted among 13 trauma patients with orthopedic injuries, known to be associated with severe pain, six weeks post-discharge. The interviews were recorded, transcribed verbatim, and thematically analyzed with an interdisciplinary approach.ResultsThe overarching theme was that discharge from the trauma centre and the period that immediately followed were associated with feelings of insecurity. The three main themes that were identified as contributing to this was (a) unmet information needs about the injury, (b) exposure to opioids, and (c) lack of follow-up after discharge from the hospital. Participants experienced to be discharged with prescribed opioids, but without information about their addictive properties or tapering plans. This, and lack of attention to mental health and psychological impact of trauma, gave rise to unmet treatment needs of pain management and mental health problems during hospitalization and following discharge.ConclusionThe findings from this study suggest that in addition to delivery of high-quality biomedical trauma care, health professionals should direct more attention to psychosocial health and safe pain management, including post-discharge opioid tapering and individually tailored follow-up plans for physical trauma survivors.

【 授权许可】

CC BY