A qualitative study of life satisfaction after surgery for adult traumatic brachial plexus injury

Author:

Dy Christopher J.12,Brogan David M.1,Rolf Liz12,Ray Wilson Z.3,Wolfe Scott W.4,James Aimee S.2

Affiliation:

1. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

2. Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA

3. Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

4. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA

Abstract

Aims Brachial plexus injury (BPI) is an often devastating injury that affects patients physically and emotionally. The vast majority of the published literature is based on surgeon-graded assessment of motor outcomes, but the patient experience after BPI is not well understood. Our aim was to better understand overall life satisfaction after BPI, with the goal of identifying areas that can be addressed in future delivery of care. Methods We conducted semi-structured interviews with 15 BPI patients after initial nerve reconstruction. The interview guide was focused on the patient’s experience after BPI, beginning with the injury itself and extending beyond surgical reconstruction. Inductive and deductive thematic analysis was used according to standard qualitative methodology to better understand overall life satisfaction after BPI, contributors to life satisfaction, and opportunities for improvement. Results Among the 15 patients interviewed, the following themes emerged: 1) happiness and life satisfaction were noted despite limitations in physical function; 2) quality of social support influences life satisfaction during recovery from BPI; and 3) social participation and having a sense of purpose impact life satisfaction during recovery from BPI. Conclusion How patients perceive their BPI treatment and recovery varies widely, and is not directly linked to their self-reported functional outcome. Patients with stronger social circles and activities that give them a sense of fulfillment were more likely to be satisfied with their current status. Evaluating a patient’s social network, goals, and potential supportive adaptations early in the treatment timeline through coordinated multidisciplinary care may improve overall satisfaction during recovery from BPI. Cite this article: Bone Joint Open 2020;2(1):9–15.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Pharmacology (medical),Complementary and alternative medicine,Pharmaceutical Science

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