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The orthopaedic trauma patient experience: a qualitative case study of orthopaedic trauma patients in Uganda.

O'Hara NN, Mugarura R, Slobogean GP, Bouchard M - PLoS ONE (2014)

Bottom Line: This methodology is subject to less bias than other qualitative methods as it imposes fewer preconceptions.Data analysis of the patient interviews (n = 35) produced over one hundred codes, nine sub-themes and three overarching themes.The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.

ABSTRACT
The disability adjusted life years (DALYs) associated with injuries have increased by 34% from 1990 to 2010, making it the 10th leading cause of disability worldwide, with most of the burden affecting low-income countries. Although disability from injuries is often preventable, limited access to essential surgical services contributes to these increasing DALY rates. Similar to many other low- and middle-income countries (LMIC), Uganda is plagued by a growing volume of traumatic injuries. The aim of this study is to explore the orthopaedic trauma patient's experience in accessing medical care in Uganda and what affects the injury might have on the socioeconomic status for the patient and their dependents. We also evaluate the factors that impact an individual's ability to access an appropriate treatment facility for their traumatic injury. Semi-structured interviews were conducted with patients 18 year of age or older admitted with a fractured tibia or femur at Mulago National Referral Hospital in Kampala, Uganda. As limited literature exists on the socioeconomic impacts of disability from trauma, we designed a descriptive qualitative case study, using thematic analysis, to extract unique information for which little has been previously been documented. This methodology is subject to less bias than other qualitative methods as it imposes fewer preconceptions. Data analysis of the patient interviews (n = 35) produced over one hundred codes, nine sub-themes and three overarching themes. The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system. Limited resources to fund the treatment of orthopaedic trauma patients in Uganda leads to reliance of patients on their friends, family, and hospital connections, and a tremendous economic burden that falls on the patient and their dependents.

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Related in: MedlinePlus

Themes and sub-themes derived from qualitative analysis.
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pone-0110940-g001: Themes and sub-themes derived from qualitative analysis.

Mentions: Data analysis produced over one hundred codes, nine sub-themes and three overarching themes. A matrix of dominant and important themes can be found in Table 2. The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system (Figure 1). Sub-themes discovered within the importance of social supports were support of family and friends and the presence of difficult social situations. The impact of and on economic resources themes were distilled into three sub-themes: personal income, benefits of income and barriers to income. Transportation to hospital, personal factors affecting healthcare and impact of income on care received were the sub-themes derived from navigating the healthcare system, the third overarching theme. (A complete summary of all codes and their frequencies is available in the Table S2.).


The orthopaedic trauma patient experience: a qualitative case study of orthopaedic trauma patients in Uganda.

O'Hara NN, Mugarura R, Slobogean GP, Bouchard M - PLoS ONE (2014)

Themes and sub-themes derived from qualitative analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215992&req=5

pone-0110940-g001: Themes and sub-themes derived from qualitative analysis.
Mentions: Data analysis produced over one hundred codes, nine sub-themes and three overarching themes. A matrix of dominant and important themes can be found in Table 2. The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system (Figure 1). Sub-themes discovered within the importance of social supports were support of family and friends and the presence of difficult social situations. The impact of and on economic resources themes were distilled into three sub-themes: personal income, benefits of income and barriers to income. Transportation to hospital, personal factors affecting healthcare and impact of income on care received were the sub-themes derived from navigating the healthcare system, the third overarching theme. (A complete summary of all codes and their frequencies is available in the Table S2.).

Bottom Line: This methodology is subject to less bias than other qualitative methods as it imposes fewer preconceptions.Data analysis of the patient interviews (n = 35) produced over one hundred codes, nine sub-themes and three overarching themes.The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.

ABSTRACT
The disability adjusted life years (DALYs) associated with injuries have increased by 34% from 1990 to 2010, making it the 10th leading cause of disability worldwide, with most of the burden affecting low-income countries. Although disability from injuries is often preventable, limited access to essential surgical services contributes to these increasing DALY rates. Similar to many other low- and middle-income countries (LMIC), Uganda is plagued by a growing volume of traumatic injuries. The aim of this study is to explore the orthopaedic trauma patient's experience in accessing medical care in Uganda and what affects the injury might have on the socioeconomic status for the patient and their dependents. We also evaluate the factors that impact an individual's ability to access an appropriate treatment facility for their traumatic injury. Semi-structured interviews were conducted with patients 18 year of age or older admitted with a fractured tibia or femur at Mulago National Referral Hospital in Kampala, Uganda. As limited literature exists on the socioeconomic impacts of disability from trauma, we designed a descriptive qualitative case study, using thematic analysis, to extract unique information for which little has been previously been documented. This methodology is subject to less bias than other qualitative methods as it imposes fewer preconceptions. Data analysis of the patient interviews (n = 35) produced over one hundred codes, nine sub-themes and three overarching themes. The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system. Limited resources to fund the treatment of orthopaedic trauma patients in Uganda leads to reliance of patients on their friends, family, and hospital connections, and a tremendous economic burden that falls on the patient and their dependents.

Show MeSH
Related in: MedlinePlus