Social capital, social exclusion and understandings of community in an urban and a rural context

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

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

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 well-managed 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

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

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

Improving recovery - Learning from patients’ experiences after injury:A qualitative study

Objectives: To explore experiences of patients after injury and identify implications for clinical care and support within the hospital setting and primary care. Design: Semi-structured telephone administered qualitative interviews with purposive sampling and thematic qualitative analysis. Participants: Patients who have experienced an unintentional injury and attended hospital. Setting: Bristol, Surrey and Swansea. Results: Key issues that emerged were: most patients reported mixed experiences of hospital care but some described the delivery of care as depersonalising; the need for clinicians to provide adequate, timely and realistic information to patients about their injury and treatment to inform their expectations of recovery; the impact of pain at the time of the injury and for an extended period afterwards; the experience of injury on patients' emotional state with possible implications for longer term mental health issues; the pivotal role of physiotherapy care in providing practical and individualised strategies for recovery; and the importance of social support for recovery. Conclusions: Trauma patients' recovery needs to be supported by information protocols. The social circumstances of patients need to be considered at the point of discharge and during recovery. There is a need to identify people who may be experiencing mental health issues for timely referral to assessment services and appropriate care. Signposting to support groups may also be helpful for those with life changing injuries. Improved pain management would help alleviate discomfort and stress. Physiotherapy has a key role to play in supporting patients in recovery. © 2013 Elsevier Ltd. All rights reserved

Understanding and meeting information needs following unintentional injury: comparing the accounts of patients, carers and service providers

Objective. To explore information needs of unintentional injury patients and their carers over time, across services, and how such needs are met from the perspectives of patients, carers and service providers

Qualitative interviews

The entry covers the place of interviews in qualitative research, conducting interviews, analysis and writing up qualitative interview studies

After ICU : the longer-term experiences of patients following discharge

Hilary Thomas, Sarah Earthy, Judith Sleney, ‘After ICU: the longer-term experiences of patients following discharge’, poster presented at the State of the Art Intensive Care Society, London, UK, 7-9 December, 2015.Peer reviewe