Understanding patients' perspectives of clinical communication within a Major Trauma Centre.

Clinical communication between major trauma patients (MTP) and healthcare professionals is extremely complex. Multiple demands are placed on specialist multi-disciplinary teams (MDT) and patients in all stages of treatment. Patient-staff clinical communication has an integral role in MTP healthcare experiences, supporting them with a range of physical and psychological difficulties post-injury. This study aimed to understand MTP perspectives of clinical communication within a MTC through qualitative semi-structured interviews. Twenty participants were purposively sampled from an outpatient follow-up clinic and interviews were analysed using a pluralistic qualitative approach. Three themes were conceptualised from the data; "Challenges to speaking up" "Conversations left me feeling" and "Strategies need to be clinical but tailored". Patients often found it challenging to speak up due to feelings of vulnerability, confusion, and challenges navigating medical terminology. Patients spoke of not wanting to burden staff and family members playing a role in patient-staff communication, but these challenges require further exploration. Patients highlighted the positive (feel reassured, cared for, and human again) and negative (feeling like an object, angry, confused, and dependent) emotional impact of staff communication. Patients also described the benefits of being provided with written information, clear explanations of injuries and person-centred communication. MTP require multiple options to communicate and address psychological difficulties. Greater training on the emotional impact of conversations, skills to respond to psychological distress and communication guidance for staff, is needed to improve clinical communication with MTP.