Mélissa Nadeau1,2, Supriya Singh3,4, Lise Bélanger1, Vanessa K Noonan2,5, Lynsey Hamilton5, Michael Boyd1,6, Nicolas Dea1,6, Brian K Kwon1,2,7, Scott Paquette1,6, John Street1,2, Marcel Dvorak1,2, Charles Fisher1,2. 1. Combined Neurosurgical and Orthopaedic Spine Program, Blusson Spinal Cord Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada. 2. Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. 3. Combined Neurosurgical and Orthopaedic Spine Program, Blusson Spinal Cord Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada. ssing44@uwo.ca. 4. Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. ssing44@uwo.ca. 5. Praxis Spinal Cord Institute, Blusson Spinal Cord Centre, Vancouver, British Columbia, Canada. 6. Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. 7. International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
STUDY DESIGN: Qualitative study. OBJECTIVES: The purpose of this study is to understand the patient perspective after diagnosis of an acute traumatic spinal cord injury (tSCI). Discussing the diagnosis and prognosis of a tSCI with a patient can be a challenging experience for both the patient and the physician. As such, this paper attempts to better understand the patient experience to improve communication when discussing this life-altering injury. SETTING: Vancouver General Hospital, Vancouver, British Columbia, Canada. METHODS: This study is a qualitative study utilizing grounded theory and semi-structured interviews. The interview transcripts were manually coded using manifest and latent content analysis. Major and minor codes were identified and discussed. RESULTS: In total, 17 interviews were conducted, fifteen individuals with tSCI who received acute care at Vancouver General Hospital (VGH) and eleven family members were interviewed. Patient participants were interviewed individually or in a paired interview with a participating family member. Patient participants had varying spinal cord injuries from AIS A-D. Two major themes were identified from the interviews. The first major theme was physician demeanor (general approach and attitude towards patients) and the second major theme was delivery of information (content, timing, and source). CONCLUSIONS: This study summarizes the preferences of patients who sustained a tSCI discussions regarding their diagnosis and prognosis in the acute care setting. The goal of this study is to help guide physician interactions at this difficult and vulnerable time for patients with hopes to improve patient care through effective communication.
STUDY DESIGN: Qualitative study. OBJECTIVES: The purpose of this study is to understand the patient perspective after diagnosis of an acute traumatic spinal cord injury (tSCI). Discussing the diagnosis and prognosis of a tSCI with a patient can be a challenging experience for both the patient and the physician. As such, this paper attempts to better understand the patient experience to improve communication when discussing this life-altering injury. SETTING: Vancouver General Hospital, Vancouver, British Columbia, Canada. METHODS: This study is a qualitative study utilizing grounded theory and semi-structured interviews. The interview transcripts were manually coded using manifest and latent content analysis. Major and minor codes were identified and discussed. RESULTS: In total, 17 interviews were conducted, fifteen individuals with tSCI who received acute care at Vancouver General Hospital (VGH) and eleven family members were interviewed. Patientparticipants were interviewed individually or in a paired interview with a participating family member. Patientparticipants had varying spinal cord injuries from AIS A-D. Two major themes were identified from the interviews. The first major theme was physician demeanor (general approach and attitude towards patients) and the second major theme was delivery of information (content, timing, and source). CONCLUSIONS: This study summarizes the preferences of patients who sustained a tSCI discussions regarding their diagnosis and prognosis in the acute care setting. The goal of this study is to help guide physician interactions at this difficult and vulnerable time for patients with hopes to improve patient care through effective communication.