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A qualitative study of coping in the early stage of acute traumatic hand injury
Örebro University, Department of Nursing and Caring Sciences. Department of Orthopaedic Surgery, Department of Hand Surgery, Örebro University Hospital, Örebro, Sweden; Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden. (Omvårdnad)ORCID iD: 0000-0002-8658-3360
Associate Professor/Senior Lecturer, Department of Nursing, University of Gothenburg, Gothenburg, Sweden.
Head of the Department of Hand Surgery, Örebro University Hospital, Örebro, Sweden.
2002 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 5, p. 594-602Article in journal (Refereed) Published
Abstract [en]

Twenty patients with acute traumatic hand injury were interviewed 8-20 days after the day of the accident. The aim of the study was to identify coping strategies, defined as thoughts or actions used by the hand-injured patients to manage stress factors and resulting emotions in the early stage. Stress factors were reported in an earlier study. The analyses of the interviews followed the first steps in the analytical process described in a modified model of grounded theory. Eleven different coping strategies were identified in the interviews. By "comparing with something worse", "positive thinking", "relying on personal capacity", "distancing" and "distracting attention" the patients tried to play down the seriousness of the problem or situation. Other coping strategies used by the hand-injured were "accepting the situation", "seeking social support", "maintaining control", "solving practical problems by oneself", "pain-relieving actions" and "active processing of the trauma experience." The findings of the study show how important it is to identify the patient's own way of coping with a stressful illness situation in order to give adequate psychosocial support.

Place, publisher, year, edition, pages
2002. Vol. 11, no 5, p. 594-602
Keyword [en]
Activities of Daily Living, Acute Disease, Adaptation; Psychological, Adult, Aged, Attitude to Health, Female, Follow-Up Studies, Hand Injuries/complications/*psychology, Humans, Internal-External Control, Male, Middle Aged, Nursing Methodology Research, Problem Solving, Questionnaires, Social Support, Stress; Psychological/*etiology/*prevention & control/psychology, Sweden
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
URN: urn:nbn:se:oru:diva-4410DOI: 10.1046/j.1365-2702.2002.00657.xISI: 000177748800006PubMedID: 12201886Scopus ID: 2-s2.0-0036718019OAI: oai:DiVA.org:oru-4410DiVA, id: diva2:138709
Projects
Consequences of an acute traumatic hand injury
Available from: 2008-02-27 Created: 2008-02-27 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Konsekvenser av en akut traumatisk handskada: en prospektiv studie av patientens situation under det första året efter olyckan
Open this publication in new window or tab >>Konsekvenser av en akut traumatisk handskada: en prospektiv studie av patientens situation under det första året efter olyckan
2003 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the research project was to investigate the consequences of an acute traumatic hand injury during the first year after the accident. The project involved 112 patients with acute traumatic hand injuries requiring inpatient hand-surgical treatment. The majority of the patients were men. Most of them were injured at home or at their usual place of work. The hand injuries differed in degree of severity. Nearly one third of the patients had amputations.

The project comprised two qualitative and two quantitative studies. Data for the qualitative studies were obtained by interviews with a theoretical sample of 20 patients between 8 and 20 days after the accident. Data for the quantitative studies were obtained from a consecutive sample of patients by means of questionnaires answered 1-2 weeks, three months and one year after the accident. All 112 patients participated in the first and 91 patients in all three assessments. The questionnaires included were the Impact of Event Scale (IES) for measuring trauma-related distress, the Hospital Anxiety and Depression scale (HAD) for measuring mood disorders and study-specific questions for measuring problems experienced. Information about injuries and accidents was obtained from the patients’ medical records.

The results of the studies showed that psychological problems were frequent the first weeks after the injury and related to consequences of both the injury and the traumatic experience. Nearly half of the patients had symptoms of traumatic stress and one third had signs of a mood disorder. Negative reactions at the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observations of the patients’ reactions when the dressing is changed might help to identify those in need of psychological support in the early stage. One third still had increased levels of traumatic stress symptoms and one out of ten had signs of a mood disorder in the one-year follow-up.

The first weeks after the accident more than half of the patients reported substantially limited physical function and had a need for help with activities of vital importance in everyday life. Troublesome pain was felt by one third of the patients. Most patients experienced significant improvement during the first three months. One year after the accident the majority of the patients had slight or moderate physical limitations. Only one out of five experienced no limitations at all. One out of seven reported troublesome pain. Patients with amputations had more pain than others both the first weeks and one year after the accident.

About 16 % were on the sick-list one year after the accident. Half of the patients back at work experienced a worse work-situation as a result of the injury. One third of all patients experienced a worse life-situation. A worse life-situation was experienced not only by patients at the sick-list but also by patients back at work. Patients with amputations and blue-collar workers more often experienced a worse life-situation than others.

In sum, this project showed how important it is that the care of patients with acute traumatic hand injuries, in addition to surgical treatment and other action for restoring function in the hand, also should include preventive action and follow-up of trauma-related distress and pain.

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2003. p. 68
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 1
Keyword
Vårdvetenskap, Hand injuries, traumatic stress, anxiety, depression, pain, outcome, nursing, omvårdnadsforskning med medicinsk inriktning
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-48 (URN)91-7668-368-0 (ISBN)
Public defence
2003-11-28, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2003-11-04 Created: 2003-11-04 Last updated: 2017-10-18Bibliographically approved

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