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Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care

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posted on 21.03.2016, 15:10 by Nicola Christie, Sarah Beckett, Sarah Earthy, Blerina Kellezi, Jude Sleney, Jo BarnesJo Barnes, Trevor Jones, Denise Kendrick
Background 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. Aim To identify good practice and unmet needs in respect of post-discharge support for injured patients. Design and setting Qualitative study using semi-structured interviews at four sites (Bristol, Leicester/ Loughborough, Nottingham, and Surrey). Method Qualitative interviews with 40 service providers and 45 hospitalised injured patients. Results 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. Conclusion Discharge from hospital after an injury can be problematic for patients. Changes in both secondary and primary care are required to resolve this problem.

Funding

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. Funding 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.

History

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Published in

BRITISH JOURNAL OF GENERAL PRACTICE

Volume

66

Issue

642

Pages

E24 - E31 (8)

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.

Publisher

© Royal College of General Practioners

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date

2015-12-07

Notes

This paper was accepted for publication in the journal Journal of General Practice and is available at http://dx.doi.org/10.3399/bjgp15X688141.

ISSN

0960-1643

Language

en