A qualitative exploration of factors influencing functional outcomes after road traffic orthopedic injuries: perspectives from Rwandan victims and healthcare providers

Abstract

Background: The burden of road traffic injury-related deaths and disabilities is disproportionately high in low- and middle-income nations. Extremity injuries impair people’s ' quality of life (QOL) in addition to the physical limitations that affect their ability to function at work and at school.

Aim: The study investigated the factors influencing functional outcomes following road traffic orthopaedic injuries victims (RTOI) in Rwanda.

Methods: Road Traffic Injuries victims treated at five Rwandan referral hospitals for orthopaedic injuries from January 1, 2019, to December 31, 2019, were interviewed in detail till data saturation. Interviews with emergency doctors, nurses, physiotherapists, and orthopaedic surgeons continued until saturation. Patients 18 and older with various orthopaedic injuries and urban or rural locations were chosen. NVivo thematic analysis was used to evaluate in-depth interview data. To minimize biases and accurately reflect participants' experiences, independent coding, detailed methodological descriptions, triangulation, member checks, peer debriefing, and reflexive journaling ensured credibility, transferability, dependability, confirmability, and reflexivity.

Findings: Our study highlights the challenges faced by healthcare providers and RTOI victims in Rwanda, including insufficient resources, long waiting times, inadequate infrastructure, and a complex referral system. These issues impair therapeutic effectiveness and prolong hospitalizations, particularly for rural patients. Timely management of RTOIs, including access to physiotherapy, early medical procedures, and psychological follow-up, is crucial for enhancing functional outcomes. Training of emergency and trauma management personnel could involve establishing basic training programs, facilitating equipment availability, setting up trauma centres, and specialised nurses.

Conclusion: This study highlights the factors that influence the functional outcome of road traffic orthopaedic injury survivors in Rwanda, as stated by the victims and healthcare providers. These injuries cause physical health issues, work disruptions, social isolation, financial pressure, and psychological suffering. Strategies to improve outcomes include patient satisfaction surveys, interdisciplinary teams, timely management, good rehabilitation services, and trauma training.