عنوان

Health care and rehabilitation for emergency lower limb surgery :

TLets810928

Health care and rehabilitation for emergency lower limb surgery :

[Thesis]

Alkhamees, Nouf Hamad

patients' and clinicians' perspectives in Saudi Arabia

University of Surrey

2014

Thesis (Ph.D.)

2014

The impact of traumatic injury goes beyond the physical aspect of the injury to encompass a range of psychological and social factors. The indirect cost due to injury may exceed the direct cost of medical care. The majority of studies on patients' experiences following traumatic injury have been conducted in Western countries with limited research in the Middle East. The current study's aim was to explore patients' experiences of healthcare services and rehabilitation following lower limb injury that necessitated emergency surgery in Saudi Arabia. Clinicians' perspectives of the planning and delivery of care for these patients in emergency settings were also investigated. A qualitative phenomenological approach was adopted using semi-structured, interviews with a purposive sample of 19 patients and 14 clinicians recruited through an orthopaedic department in a Riyadh hospital. Thematic analysis was used, drawing on the Biopsychosocial model as an overarching theoretical framework and the Illness Trajectory Framework. Patients' experiences were influenced by the availability of emotional support, their involvement in decision-making, and preparedness for treatment, including preoperative information. Belief systems, cultural and religious values were crucial in shaping patients' experiences of and interactions with healthcare services. The hospital admission process and the chain of referrals limited the time clinicians were able to spend with patients before surgery. Clinicians also identified challenges such as lack of continuity of care, administrative support, poor communication and inter-professional collaboration during healthcare delivery, some of which mirrored the perspectives of the patients. Clinical practice in Saudi Arabia may benefit from a triage system to give clinicians more time for trauma care. There is a need to improve communication and inter-professional collaboration and for policy makers to review working conditions for healthcare professionals in the traumatic injury care sector. Future research should focus on the longer-term psychological, physical and social consequences of lower limb injury. Key words: Injury, surgery, emergency, healthcare, culture, religion, recovery.

University of Surrey

University of Surrey

p

[Thesis]

276903

a

Y