Adolescent Experience with Trauma and External Fixation

描述(申请人提供)：每年有超过1300万名青少年遭受创伤性伤害，其中许多会导致功能残疾、毁容、心理社会问题和骨折。这些骨折越来越多地使用骨科外固定装置(EFD)进行治疗，这种装置具有外部金属框架和骨骼钉，可以穿透皮肤(钉部位)固定在骨骼中，从而稳定骨折。尽管EFD对骨折有很好的治疗效果，但针部感染是一个严重的问题，特别是在青少年中，他们可能也会经历EFD治疗带来的不利心理社会影响。针式护理自我管理对预防感染至关重要，但尚未在青少年中进行研究，也没有研究EFD治疗对遭受创伤性损伤的青少年的影响。在拟议的纵向定性描述性研究中，12-20岁的青少年将在创伤后应用EFD进行3次访谈。用青少年的话来说，其具体目的是描述1)导致创伤事件的情况，2)受伤后的日常经历，3)与EFD的日常经历，以及4)青少年在创伤恢复期间的自我护理管理中的作用。拟议的研究将为今后可能改善预防和创伤后护理和康复的研究奠定基础，重点是了解遭受重大创伤和目前正在接受EFDS治疗的青少年的经历。

DESCRIPTION (provided by applicant): Over 13 million adolescents sustain traumatic injuries yearly, many resulting in functional disability, disfigurement, psychosocial problems and fractures. These fractures are increasingly being treated with orthopedic external fixation devices (EFDs), which have external metal frames and skeletal pins that penetrate the skin (pin site) to anchor in the bone, thus stabilizing fractures. Although EFDs yield superior outcomes for fractures, pin-site infections are a serious problem, particularly in adolescents who may also experience detrimental psychosocial effects from EFD treatment. Pin-care self-management, crucial to preventing infection, has not been studied in adolescents, nor has the impact of EFD treatment on adolescents who sustain traumatic injuries. In the proposed longitudinal qualitative descriptive study, a purposive sample of adolescents, 12-20 years old, will be interviewed 3 times after EFDs are applied for traumatic injury. The specific aims are to describe, in the adolescents' words, 1) circumstances leading to the traumatic event, 2) day-to-day experiences following the injury, 3) day-to-day experiences with the EFD, and 4) the adolescent role in pin-care self-management while recovering from trauma. The proposed study will lay the groundwork for future studies that may improve preventive and post-trauma care and recovery by focusing on understanding experiences of adolescents who have sustained major trauma and who are currently being treated with EFDs.