Consequences and adaptation in daily life - patients' experiences three decades after a nerve injury sustained in adolescence

Background: To explore the patients' experiences during the three decades following repair of a nerve injury in the forearm and its consequences for daily life. Strategies that were used to facilitate adaptation were also investigated. Methods: Fifteen participants with a complete median and/or ulnar nerve injury repaired in the ages from 13-20 years were interviewed using a semi-structured interview guide. The median follow-up time was 31 years (range 23-40). The participants were asked to describe the past and present symptoms of the injured hand, the consequences of the injury for daily life, personal qualities and support from others. In addition, they were asked to describe strategies used to facilitate adaptation. The interviews were subjected to content analysis. Results: The nerve injury lead to sensory and motor deficits in the injured hand, as well as sensitivity to cold and secondary back problems. Emotional reactions to trauma and symptoms related to post-traumatic stress disorder were described, as well as how they managed to cope with such reactions. There was a noticeable impact on education, leisure, professional or domestic life for some, while others could continue by changing e. g. their performance pattern. The participants' life roles and relations were also affected. Both emotion-and problem-based strategies were used to manage challenges in daily life. Conclusions: The present qualitative study can help us to provide the patient with honest and realistic information about what to expect after a nerve injury at forearm level, without eliminating hope. Emotional reactions to trauma should be identified and dealt with. In addition, health-care professionals can promote a variety of coping mechanisms to facilitate daily living for the injured patients