Sarah Norris, an advanced occupational therapist at the Newcastle Hospitals has had an article accepted for publication in Trauma – a peer reviewed scholarly journal which brings together a wide range of topics of interest to all those involved in the management of trauma patients world-wide.
Sarah was lead author for the article ‘Patient perspectives of recovery following major musculoskeletal trauma: A systematic review and qualitative synthesis’ – the result of an NMAHP (nursing, midwifery and AHP) internship.
Sarah explained “Improved survival following major trauma has resulted in an increased number of patients with complex physical, functional and psychosocial needs requiring specialist multidisciplinary rehabilitation.
A key challenge in modern trauma care is to deliver rehabilitation interventions that translate into improved outcomes.
Sarah Norris, advanced occupational therapist
“I decided to conduct a systematic review all research literature investigating patients’ perspectives of recovery following major trauma to bring all results together.”
The project turned out to be bigger than originally thought, with initial searches identifying over 5000 articles.
Value of qualitative evaluation
The qualitative synthesis found that recovery following major musculoskeletal trauma has physical, psychological and socio-functional dimensions. Successful recovery involves ‘crafting a new normal’ and is both a process and an outcome, with milestones of participation in meaningful activities (occupations).
Sarah reported that three major themes were identified:
- vulnerability
- learning to manage
- adaptation and adjustment.
She noted that patients do not experience each theme in a linear way; rather they move through the recovery process in an individualised and cyclical manner.
Therefore in conclusion, organisationally, an effective multi-disciplinary team model of care is essential to support survival as a long-term condition across the trauma care continuum.
Building research capacity and capability
Sarah’s project began in 2021 as part of an NMAHP (nursing, midwifery and AHPs) internship funded by Newcastle Hospitals Charity, which supported Sarah to be released from clinical practice for one day a week to conduct her research.
“The NMAHP research internship was a starting point for me to develop my networks and experience and gave me breathing space to ‘look up’ from clinical work,” explained Sarah.
“This, along with the fantastic 4Ps researcher development training offered by the NMAHP research team was very encouraging and helped me cultivate networks beyond my clinical area, as well as that ‘space’ to contemplate next steps.”
Sarah added “I have always been interested in using data to evidence our value and support decision making, as well as improving services through audit and evaluation.
“What became apparent to me was the lack of holistic measurement of the value of occupational therapy in the hospital process. This is because OTs are traditionally associated with discharge planning and providing equipment, yet my interactions with patients are much more complex than this”.
Powerful synergies leading to further publications
Sarah is committed to continue furthering her research career. “A previous colleague forwarded me an email invitation to a James Lind Alliance (JLA) research priority setting partnership (PSP) workshop on complex fractures,” she explained. “On the back of that, when a call went out for an OT to join their steering group for the Major Trauma PSP, I responded.
“A research priority identified by the James Lind Alliance for both complex fractures and major trauma injuries is discovering which outcomes are important to patients. This work has inspired me to develop my own research further to address these priorities, in line with my own experiences.
“My work with the JLA has been a fantastic journey through participatory research and was recently published in the BMJ: https://bmjopen.bmj.com/content/14/5/e083450”
Sarah cites the importance of having good support “I was lucky to work clinically with Lisa Robinson, an Allied Health Professional Consultant, and then on this project. She provided guidance and knowledge with the writing process as well as enthusiasm, and motivation as we approached the end of the project.
“Having a consultant and clinical leads from the Major Trauma Rehabilitation Service involved in the project really helped to deliver a tangible ‘output’.”
Of Sarah’s successes to date Dr Lisa Robinson said “These publications are highly patient-focused and relevant to clinical practice. Sarah is hugely respected in her field, as both an experienced senior occupational therapy practitioner and applied health researcher.
“Her work to improve our understanding of patient experience following major trauma, with a focus on the outcomes that matter to individuals and their family members, will have real-world impact on the quality and relevance of targeted rehabilitation provision for this patient group at a local, national and international level.”
How you can #MakeSpace4Research
If you are interesting in finding more about the opportunities available within the Research Development Institute funded by Newcastle Hospitals Charity, please see here.
Please see here if interested in The 4 Ps: a welcoming jargon-free modular programme. The four modules are Place, Project, Person, and Plan, and they provide you with the skills, knowledge and confidence to move forward with research.
Sarah’s publications
Sarah was lead author for the article “Patient perspectives of recovery following major musculoskeletal trauma: A systematic review and qualitative synthesis” Published 15 November 2023.
Sarah conceived the study with colleague Consultant AHP Lisa Robinson and worked alongside fellow trauma rehabilitation expert Sinead Savory, Major Trauma Rehabilitation Service, Rehabilitation at the RVI, Laura Graham (Consultation in Rehabilitation Medicine, Major Trauma Rehabilitation Service, RVI / Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Lynne Wilkinson, Major Trauma Rehabilitation Service, Rehabilitation at the RVI.
Sarah participated in a collaboration of 23 experts on behalf of the BMJ Open’s Trauma Priority Setting Partnership Steering Group on “Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance” Published 15 May 2024.
James Lind Alliance
The James Lind Alliance (JLA) is a non-profit making initiative established in 2004. It brings patients, carers and clinicians together in Priority Setting Partnerships (PSPs) to identify and prioritise the unanswered questions or evidence uncertainties that they agree are most important for research to address.
The National Institute for Health and Care Research (NIHR) funds the infrastructure of the JLA to oversee the processes for PSPs, based within a small team at the School of Healthcare Enterprise and Innovation, University of Southampton.
