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. 2021 Mar 4;11(3):e041442.
doi: 10.1136/bmjopen-2020-041442.

Neurotrauma clinicians' perspectives on the contextual challenges associated with long-term follow-up following traumatic brain injury in low-income and middle-income countries: a qualitative study protocol

Brandon George Smith  1   2 , Charlotte Jane Whiffin  2   3 , Ignatius N Esene  4 , Claire Karekezi  5 , Tom Bashford  2 , Muhammad Mukhtar Khan  2   6 , Davi Jorge Fontoura Solla  2   7 , Bhagavatula Indira Devi  2   8 , Peter John Hutchinson  1   2 , Angelos G Kolias  9   2 , Anthony Figaji  2   10 , Andres M Rubiano  2   11
Affiliations

Neurotrauma clinicians' perspectives on the contextual challenges associated with long-term follow-up following traumatic brain injury in low-income and middle-income countries: a qualitative study protocol

Brandon George Smith et al. BMJ Open. .

Abstract

Introduction: Traumatic brain injury (TBI) is a global public health concern; however, low/middle-income countries (LMICs) face the greatest burden. The WHO recognises the significant differences between patient outcomes following injuries in high-income countries versus those in LMICs. Outcome data are not reliably recorded in LMICs and despite improved injury surveillance data, data on disability and long-term functional outcomes remain poorly recorded. Therefore, the full picture of outcome post-TBI in LMICs is largely unknown.

Methods and analysis: This is a cross-sectional pragmatic qualitative study using individual semistructured interviews with clinicians who have experience of neurotrauma in LMICs. The aim of this study is to understand the contextual challenges associated with long-term follow-up of patients following TBI in LMICs. For the purpose of the study, we define 'long-term' as any data collected following discharge from hospital. We aim to conduct individual semistructured interviews with 24-48 neurosurgeons, beginning February 2020. Interviews will be recorded and transcribed verbatim. A reflexive thematic analysis will be conducted supported by NVivo software.

Ethics and dissemination: The University of Cambridge Psychology Research Ethics Committee approved this study in February 2020. Ethical issues within this study include consent, confidentiality and anonymity, and data protection. Participants will provide informed consent and their contributions will be kept confidential. Participants will be free to withdraw at any time without penalty; however, their interview data can only be withdrawn up to 1 week after data collection. Findings generated from the study will be shared with relevant stakeholders such as the World Federation of Neurosurgical Societies and disseminated in conference presentations and journal publications.

Keywords: neurological injury; neurosurgery; qualitative research.

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Conflict of interest statement

Competing interests: AGK and PJH are supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre and the NIHR Global Health Research Group on Neurotrauma. PJH is also supported by an NIHR Research Professorship. The NIHR Global Health Research Group on Neurotrauma was commissioned by the UK NIHR using Official Development Assistance funding (project no. 16/137/105). INE, CK, MMK, DJFS and AGK are members of the Young Neurosurgeons Committee of the World Federation of Neurosurgical Societies. The committee is supporting this project.

References

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