PATIENT'S PERCEPTIONS ON THE EFFECT OF MENTAL HEALTH ON THEIR RECOVERY OF PHYSICAL FUNCTION FOLLOWING POLYTRAUMA INJURY IN SOUTH AFRICA

M.A. Reis¹, M. Keller¹, H. Van Aswegen¹

¹The University of the Witwatersrand, Physiotherapy, School of Therapeutic Sciences, Johannesburg, South Africa

Background: The prevalence of polytrauma is increasing globally and in South Africa, resulting in a contribution to the already increasing rate of disability. Early health care intervention in the acute care setting has been shown to reduce the risk of complications and facilitate functional recovery of patients sustaining polytrauma injuries. There is minimal evidence exploring the patient’s perceptions of the impact of mental health on the recovery of physical function following polytrauma injury in an acute care and outpatient setting. The mental health of patients who sustain polytrauma injuries is not to go unnoticed. Literature shows that emotional trauma results from the magnitude of the shock associated with the mechanism of injury, fear of a threat to life, and the perception of possible negative consequences.

Purpose: To explore patient's perceptions on the effect of mental health on the recovery of physical function following polytrauma injury.

Methods: A qualitative single case study design comprising of nine semi structured interviews with key informants, selected through purposive and snowball sampling, was employed in a private trauma facility in Johannesburg. Inductive thematic data analysis was conducted utilising MAXQDA to derive codes and themes from the interview transcripts. Trustworthiness strategies were employed to ensure rigour in this research.

Results: Participants expressed that their mental health status significantly impacted their physical function recovery. The themes which arose included posttraumatic stress disorder symptoms, feelings of terror, hallucinations, disorientation, nightmares, inability to allow others physical contact with the injury sight, residual pain and feelings of body disfigurement, and the need to the seek medical intervention for such pain. Although pain was a limiting factor, limited work reintegration or even inability to return to work was often preceded by the fear of ability to return to work. Difficulty reintegrating into the community due to both physical injury and poor mental health was noted. Some participants were able to get back to work or find new work but noted that this was only after concerted and prolonged efforts working to maintain a positive mindset or gaining mental support from ones’ religious belief systems.

Conclusions: Factors influencing patient’s perceptions of the impact of mental health on their recovery of physical function following polytrauma injury are multifactorial. Most noteworthy is that interpersonal relationships and support structures significantly influence patient’s perception of care. Further research is reccomended to unpack the impact of mental health on return to work and community re integration needs.

Implications: This study may inform clinical practice in the management of patients sustaining polytrauma injuries, by addressing barriers and promoting facilitators identified. The study may also be used to inform policy related to patient management following polytrauma injury.

Funding acknowledgements: The author would like to acknowledge the South African Society of Physiotherapy for the masters research grant

Keywords:
Patient’s perceptions
Polytrauma
Mental health

Topics:
Mental health
Service delivery/emerging roles
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: The University of the Witwatersrand

Committee: UNIVERSITY OF THE WITWATERSRAND HUMAN RESEARCH ETHICS COMMITTEE (MEDICAL)

Ethics number: M200951