Trauma patients perception of the trauma experience.

A grounded theory study was conducted to identify, describe and provide a theoretical analysis of the conditions and events surrounding the occurrence of physical trauma. Research questions addressed were: What pattern of behavior is present in individuals prior to experiencing a motor vehicle collision (MVC)?; To what degree do trauma patients view themselves as active participants in a MVC that results in physical injury? Twenty one informants participated in the study. Theoretical sampling involved the use of a variety of sources of data. Vignettes, interviews, songs, commercials and automobile advertisements were triangulated with existing literature. Constant comparative analysis revealed a grounded theory of self protection. Self protection consists of three phases; perceptions of actual control over the environment, experiencing a traumatic event that signifies loss of control over their environment, and self protection to enhance perceptions of actual control over the environment post event. Controlling perceptions influenced use of protection devices and post trauma driving behavior. Self protection involved emotional focused and problem focused strategies similar to that described in the literature. Perceptions of actual control over the environment was not a static trait but appeared to be situationally dependent. The theory explained the behavior of the majority of the informants regardless of their mechanisms of injury; although patients with injuries resulting from violence were omitted from the study. Informants who viewed driving as a pleasurable action with unpredictable outcomes, as a form of risk taking behavior, did not identify self protection strategies post event. The other informants viewed driving as an unconscious, automatized behavior and denied engaging in risk taking prior to the MVC. Findings indicate the need to explore the social context of the American lifestyle and the image of the automobile when explaining self protective strategies. Automobile manufacturers provide the illusion of control over the environment in their advertisements perhaps negating the need for self protection. Rationale for not supporting mandatory protection for the use of seat belts and helmets was provided by the informants. Further testing with contrasting groups is indicated to determine the usefulness of the theory outside the trauma patient population