Neurotrauma clinicians’ perspectives on the contextual challenges associated with traumatic brain injury follow up in low-income and middle-income countries: A reflexive thematic analysis

• DOI: 10.1371/journal.pone.0274922
• Publication Date: 2022-09-19T17:31:35Z
• Authors: Brandon G. Smith; Charlotte J. Whiffin; Ignatius N. Esene; Claire Karekezi; Tom Bashford; Muhammad Mukhtar ...; Davi J. Fontoura ...; Bhagavatula Indir...; Wellingson S. Paiva; Franco Servadei; Peter J. Hutchinson; Angelos G. Kolias; Anthony Figaji; Andres M. Rubiano
• Keywords: Thematic Analysis; Reflexivity; Global Health

Background Traumatic brain injury (TBI) is a major global health issue, but low- and middle-income countries (LMICs) face the greatest burden. Significant differences in neurotrauma outcomes are recognised between LMICs high-income countries. However, outcome data not consistently nor reliably recorded either setting, thus true burden of TBI cannot be accurately quantified. Objective To explore specific contextual challenges of, possible solutions to improve, long-term follow-up following low-resource settings. Methods A cross-sectional, pragmatic qualitative study, that considered knowledge subjective reality multiple (i.e. situated within naturalistic paradigm). Data collection utilised semi-structured interviews, by videoconference asynchronous e-mail. were analysed using Braun Clarke’s six-stage Reflexive Thematic Analysis. Results 18 neurosurgeons from 13 participated this analysis gave rise five themes: Clinical Context: What must we understand?; Perspectives Definitions: talking about?; Ownership Beneficiaries: Why do it?; Lost Follow-up: Who misses out why?; Processes Procedures: do, or what might do? Conclusion The plays an imperative role reducing neurotrauma. Therefore, was exploratory study examined associated with LMICs. Where technology can contribute improved surveillance remote assessment, these implemented manner improves patient outcomes, reduces clinical on physicians, does surpass comprehension, capabilities, financial means end user. Future research recommended investigate family perspectives, impact care teams, full economic implications new technologies for follow-up.