Impact of Injury on the Level of Quality of Life In Adult Individuals after Traumatic Brachial Plexus Injury and Understanding the Individual s Journey and Experience to Recovery

Abstract

Brachial plexus injury can be Obstetric (congenital) or Traumatic (due to high impact newlinevehicular road traffic accidents) resulting into severe injuries of the upper extremity newlinewith motor and sensory impairments. This devastating injury most commonly affects newlineyoung men between 20-30 years of age, causing a heavy load on their physical, newlineeconomical, psychological, emotional and social aspects of life. newlineSurgical treatment and rehabilitation of these injuries take much longer time than any newlineother peripheral nerve injury. There may be a possibility that the impact of injury and newlinetreatment intervention can influence patient s quality of life. The main goals of newlinereconstructive surgery according to surgeons are to restore motor functions and protective newlinesensations whereas the patient s main concern maybe restoring his ability to live newlineindependently and return to work. newlineThe study was planned in two steps as study 1 (Quantitative study) with the aim as to newlinedetermine the level of quality of life and evaluate the factors influencing the quality of newlinelife in adult individuals following traumatic brachial plexus injury. The second step was newlineaccomplished in study 2 (Qualitative study) aiming to explore the individual s journey newlineand experience to recovery after the traumatic incidence of brachial plexus injury. newlineWe carried out this Sequential Explanatory Mixed Method study in two parts with newlineQuantitative study followed by Qualitative study. In first part of study we tried to newlineencompass understanding quality of life and determining its influencing factors with the newlinehelp of patient rated subjective outcome measures like WHOQOL-BREF, DASH newlineQuestionnaire, Br-COPE and physical motor function assessment along with detailed newlinedemographic data. Descriptive statistical analysis was carried out to assess change in newlinepre and postoperative values of quality of life, Functional ability of upper limb, coping newlinelevel and physical motor function of upper limb in TBPI individuals. Univariate and newlinemultivariate regression analysis was carried out to evaluate the contributing factors newlinerelated to life of individual after TBPI, injury and surgical treatment received which newlinemight have had influence on quality of life. newlineThe second part was qualitative study planned with phenomenological approach. In newlinedepth, face- to face interviews of participants sustained with Traumatic Brachial Plexus newlineinjury were conducted using non-directive, open ended questions based on validated newlinexxvii newlineinterview guide. This interview guide was prepared with the help of pilot results newlineobtained from quantitative data and under expert guidance of professor of sociology from newlineTata Institute of Social Sciences, Mumbai. The analysis of qualitative data collected newlinethrough interviews was done by using Interpretative Analytical Phenomenon (IPA) to newlinegain the insight into the individual s perception of impact of injury on his/her life and newlinehow he/she dealt with it following traumatic brachial plexus injury. newline newline