Trauma recovery: An ethnography

The advances in technology, life support and transport procedures have increased the survival for victims of traumatic accidents. However, many survivors have been left with residual psychological and physical deficits. This study attempted to capture the lived experience of trauma by examining the social environment in which people confronted life threatening injuries and how that event became meaningful for them.^ A prospective study design documented the process of change that occurred to thirty trauma victims over fourteen months. The design was intended to uncover the physical and emotional changes these victims sustained and to identify factors that facilitated or impeded recovery. An anthropological approach let the informants speak for themselves, and examined their recovery in the hospital, rehabilitation facility, and home.^ Data were collected by limited participant-observation and intensive in-depth interviewing at several points during the recovery process. Trauma victims, their families, physicians, and nurses were participants in the data collection.^ Coding categories that were abstractions of the themes and topics emerging from the ethnographic materials were developed. The coding process extended from the specific statements in the interviews, to a more abstract level, and back to specifics to determine if the various parts continued to weave a congruent whole. Returning to the informants to confirm new insights helped to increase validity. Three qualitative researchers were given four interviews to code, and interrater reliability was calculated to be.89.^ At the end of the fourteen months, thirteen of thirty informants did not describe themselves as recovered. Characteristics that this group shared were depression, permanent physical injury, and disfiguring scars. Pre-existing personality and social support did not have a significant effect on recovery. The seventeen who were recovered had shorter hospital stays, full physical recovery, and had returned to work. The general typology of responses that was common for all the informants involved three stages of recovery; crisis, healing, and recovery. Themes identified from the ethnographic data that have ramifications for intervention studies include a sense of abandonment after discharge, insensitive pain management, and prolonged grief reaction.