Major traumatic physical injury in young people during the initial six month injury trajectory: an explanatory sequential mixed methods study

Abstract

Background: Injury accounts for 10% of worldwide mortality for all ages and causes profound functional deficits up to five years following injury, particularly in the young person population. These outcomes have devastating effects on social and emotional development as well as occupational prospects. There is insufficient understanding of the characteristics and experiences of injury in young people and the role of the family in their recovery from injury. Aim: To explore, for young people aged 16 -24 years, the characteristics and experience of major traumatic physical injury and the role of family in the initial six months. Methods: An explanatory sequential mixed methods design with a primary qualitative drive was used. In Phase 1, two epidemiological studies determined the incidence, characteristics and outcomes of major traumatic injury incurred by people in the Australian Capital Territory (ACT) and surrounding districts. These data provided sampling priorities for the subsequent primary qualitative phase. Phase 2 comprised two semi-structured in-depth interviews (in hospital and at 6 months following injury) with 12 injured young people and their family member/s. In Phase 3, findings were integrated. Findings: The largest demographic group affected by major injury was people aged 16-24 years. Road trauma was the most prevalent injury mechanism (58.4%), followed by recreation (15.4%) and violence (15.3%). Young people feel vulnerable and that they had lost control over their physicality, environment and life-course. Self-management strategies included using information technology as a form of distraction and family and friends to create a sense of normality. A young people's understanding of their recovery differed from how healthcare systems are structured to provide care. Driven by a need to protect the young person, family members sought to control potential emotional impacts of injury by creating a buffer between the young person and other people. Conclusion: For the first time, the initial six month injury trajectory and recovery process of injured young people has been conceptualised to inform the development of anticipatory guidance frameworks for clinicians and inform the provision of, and planning for, clinical services for injured young people.