title: Indicators of injury recovery identified by patients, family members and clinicians.
abstract: BACKGROUND
  A focus on what is important to patients has been recognized as an essential pillar in care to ensure safe patient care that focuses on outcomes identified as important by patients. Despite this, asking trauma patients and their families what they consider should be the priorities of care and recovery has been neglected.
  
  
  METHODS
  Adult trauma patients admitted to two centers in Australia for ≥24h for the treatment of physical injury, and family members of injured patients and clinicians caring for injured patients were invited to participate. Individual interviews were conducted with the patient and family members prior to hospital discharge, and again one and three months post discharge. Individual interviews or focus groups were conducted with clinicians at one point in time. Content analysis of all transcripts was undertaken to determine the indicators of successful recovery over time.
  
  
  RESULTS
  Participants in the three stakeholder groups were enrolled (patients - 33; family members-22; clinicians-40). Indicators of recovery focused on five main categories including returning to work, resuming family roles, achieving independence, recapturing normality and achieving comfort. Other categories that were less frequently identified included maintaining one's household, restoring emotional stability, cosmetic considerations and appearance, realignment of life goals, psychological recovery and development of self. Indicators of recovery after physical injury were similar across the three stakeholder groups, although with greater detail identified by patients. In addition, indicators evolved over time with increasing recognition of the importance of the overall impact of the injury in general and on activities of daily living and an unfolding appreciation that life could not be taken for granted.
  
  
  CONCLUSIONS
  Description of the indicators of recovery after traumatic injury that matter to patients, family members and clinicians enable an understanding of similarities and differences. Further testing in a broader cohort of participants is essential to identify patient reported outcome measures that might be used in trauma care and associated research.
authors: Nursing School of Health Sciences, City, University of London, United Kingdom; Menzies Health Institute Queensland & School of Nursing and Midwifery, Griffith University, Australia; Intensive Care Unit, Princess Alexandra Hospital, Australia. Electronic address: Leanne.aitken.1@city.ac.uk.
authors: Leanne M
authors: LM
authors: Aitken
authors: NHMRC Centre of Research Excellence in Nursing (NCREN), Menzies Health Institute Queensland & School of Nursing and Midwifery, Griffith University, Australia.
authors: Wendy
authors: W
authors: Chaboyer
authors: Princess Alexandra Hospital, Australia & School of Nursing and Midwifery Griffith University, Australia.
authors: Carol
authors: C
authors: Jeffrey
authors: National Critical Care Trauma Response Centre, Royal Darwin Hospital, Australia.
authors: Bronte
authors: B
authors: Martin
authors: Health Economics, Norwich Medical School, University of East Anglia, Norwich, UK; Menzies Health Institute Queensland & School of Medicine, Griffith University, Australia; School of Pharmacy, The University of Queensland, Australia.
authors: Jennifer A
authors: JA
authors: Whitty
authors: Charité Hospital, Humboldt University Berlin, Germany.
authors: Michael
authors: M
authors: Schuetz
authors: School of Nursing, University of Pennsylvania, United States.
authors: Therese S
authors: TS
authors: Richmond
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D011788:Quality of Life; D012944:Social Support; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*
keywords: Health priorities; Outcome assessment; Patient reported outcomes; Patient-centred care; Recovery; Trauma