• Subject Name : Nursing

Psychological Factors and Recovery from Trauma

Introduction to Road Injury-Related Trauma of Norway

The purpose of the study is to choose a population that is under serious threat of a particular trauma as the client is to be treated understating the condition and situation under which he or she is moving. The nature of the traumatic condition of the population is to be identified. The experience of the client population is to be revealed. The factors related to the traumatic condition are to be analyzed. The issues associated with the traumatic condition are to be analyzed (Kristiansen et al., 2014). The analysis of the client's population condition along with the factors responsible will provide a necessary clue to take appropriate action for the client. The appropriate action will help in the prevention and control of the trauma caused to the target population. The approaches to the intervention will be undertaken. The intervention approaches will be extracted from the factors associated with the trauma. The identification of the client population under several, trauma, factors that contribute to the trauma and intervention required to prevent the trauma, and the awareness methods will all be taken from the chosen literature. The study will further reflect on the learning experiences received from the study and the assignment. The study is focused on the rural population of Norway who has affected by the road accidents as 51% population are found to have affected due to transport accident in a rural area (Kristiansen et al., 2014). In the urban area in Norway, the rate of morbidity and mortality is lesser as there is a good traffic control facility. The mortality is higher in the rural region due to uncontrolled traffic. The uncontrolled traffic has enhanced the rate of incidents in the regions and has deeply affected the population more largely.

The Rationale for The Choice

The client is a rural patient associated with a road accident. The road accident caused immense damage to the psyche, and the analysis of the road accident is essential in the context of Norway.

The trauma population was chosen as the urban infrastructure has enough facility to treat the patient with the utmost care and consideration and prevent them from mortality and morbidity, but the death rate related in a rural region is higher as the chance of recovery for the patient is lesser as there is a lack of proper infrastructure and trauma care facility. The absence of a trauma care facility has deeply affected the rural population. The clients that come under the accidental influence are deeply in trouble, and most the victims do on the road or in the hospital (Wisborg, Hoylo & Siem, 2003). Those clients who have been saved from the accidental injury are the extreme victim of trauma. They suffer the huge financial and social loss, and therefore, the choice of the population has been done as there is a sort of ignorance towards the trauma care in the rural region. It is found that traumatic injuries among the young rural population are found to be more severe. It not only influences the injured but also affected the people around the injured. The family and relatives are also more affected by the injury of the young in the rural region of Norway (Kristiansen et al., 2014). The study found that there is an increasing caseload in rural hospitals with potentially injured patients in the hospitals of Norway. The hospitals could hardly manage the patient with caseload and the potentially injured patient has to lose the life, and in most cases, the saved clients faced extreme crises associated with trauma. From the study of 2011, it is found that there is a significant regional difference in the distribution of trauma patients (Kristiansen et al., 2014). There are hospitals in rural regions where the trauma patient is received less than 100 annually, but the count is much higher in some regions. There are hospitals in the rural region where the hospitals receive less number of patients. The issue of trauma due to road accident-related injury has been taken as Trauma is still regarded as a challenge in the health care system. As the health care system is still incapable of managing the extreme trauma, it is necessary to research the trauma and identifies the factors responsible for causing the trauma to prevent the patient from dying from a similar cause of death (Wisborg et al., 2003).

Identify Specific Factors for Trauma

Transportation is found to be the major cause of the study as it brings about 51% of trauma in the rural region. There is a growing effect of the trauma over the population as the road traffic is continuously increasing along with the number of incidents. The increased traffic and increased concentration of the vehicles on the rise are the cause of more injury and road-related injury that5 has affected the patients deeply. Norway is a country of a small network, and the total population of the country is 4,920,305 (Kristiansen et al., 2014). It is found that the medical facilities provided by the hospitals are only in 19 counties (Wisborg et al., 2003). There is a decreasing number of trauma patients, but there is still a rise in the trauma patient caused by road accidents. The cause of the increased trauma is the lack of facility to transfer the patient from acute care hospitals to the trauma centers (Wisborg et al., 2003). There is a lack of facility of availability of doctors to treat the road accidents, the on-call ambulance services hardly response in the extreme crisis. There are only 12 helicopter services to manage road accident patients. The 12 helicopter service is insufficient and in the rural regions. The population from the rural region is found to be at higher risks. It is found that in the rural region, the death rate among the male population is 78% (Kristiansen et al., 2014). Though the national trauma rate is 28.7%, there is a huge difference between population density and immortality. The attempt has been made by the government to reduce the death rate. The majority of death rate occurs in the pre-hospital phase. The centralized services in the rural population have helped to promote the debate of the centralization (Kristiansen et al., 2014). There are factors responsible for death and mortality, and it requires a joint effort from the medical practitioner and government. 

Lack of focus on the centralization of trauma care

The centralization of care was not focused despite the rising issue of road accidents and resulting trauma care (Davenport, 2014). Though Traumatic patient is on the rise, there is still optimal initial stabilization along with the emergency medical services. There is still a lack of effective inter-hospital transfers in the rural region. The strategy to identify the high-risk area is still research.

Fatal injury in the road accident

There is a growing number of road accidents within the region due to the fatal injury of the people associated with the loved one (Giummarra et al., 2019). The uncontrolled traffic system in the rural region causes more death, and the feeling about the dead ones becomes the cause of trauma for many people. It has been identified that the drunk-driving became the cause of many deaths within the region. The fatal traffic accidents cause death and trauma at an equal rate in the rural region of Norway.

Lack of system for injury prevention

There is a lack of effective preventive care within the countries to injured patients. The delay in care delivery made it difficult for the patient to bear the system. The delay in care delivery traumatizes the patient is a great way (Hubele & Kennedy, 2018). It is also found that rural road accident victims die on the road without receiving proper care and consideration. The lack of care system is to prevent injury in the road accident.

The inefficient first aid system

The countries within the counties have little first aid facilities to provide the injured patient. The lack of initial care negatively affected the clients' psyche. The impact on the client is deep and disturbing. The client's population is under the extreme crisis that has affected the psyche of the client and the family is a disastrous way (Kristiansen et al., 2014). The psyche of the client has deeply affected the mental condition that leads to several disorders to the patient. It is also found that the majority of death (86%) occurred in the pre-hospitalization phase. The road accident death in the entire country is combined is 21% (Kristiansen et al., 2014).

Rural Higher injury rate

It is found that rural death by injury is higher than it is found in the urban region. It is found that a large portion of trauma patients died of injury at the stage of the injury site. It is found in the rural region of the Scandinavian Peninsula, the death rate was maintained above the Norwegian region. The death at the site of injury is caused by the delay in response, discovery, and transport times (Kristiansen et al., 2014). The impact of rural regions on the trauma is growing. The majority of death, as it is discovered, happened in the transport category. In the central municipalities, the death rate is found to be enhanced. It is found that mortality in the rural region higher than what is found in the urban region.

Delay in discovery

Delay in discovery is important in a rural region. The rural region provides little facility to the patient as the discovery time in the road accident is delayed. The delay causes the initial death of the patient injured severely (Kristiansen et al., 2014).

Delay in response

Though the case of road accidents is discovered, the response from the health care system is delayed in the rural region. The delayed response affects the patient more profoundly.

Severity of injury

The death and trauma largely depend on the severity of the injury that occurred to the patient in the road accident. The road accident in most cases affects the patent more intensely. The intense accident affects the patient more deeply. The injury of the patient can affect the patient. The delay initial care enhanced the trauma in the most severe case of injury (Kristiansen et al., 2014).

Lack of access to a specialized system in the rural region

It is often the case that rural area is not focused, and the health care system is not efficient enough to provide effective care to the road accident patient. It is also found that there is a lack of trauma care in the country even in the urban region. The medical system of the rural region of the country is less effective and affecting. The pre-hospital death was found to be the most common thing found in road accident cases. 

Outline Any Issues Associated with This Traumatic Situation

The issues associated with the road accident that is needed to be focused by the practitioners are the instant care and soothing to the family. The practitioners need to provide more efficient care to the client with the road accident injury. The practitioner needs to be aware of the high-risk region and needs to be well-prepared to treat the patient and provide effective care to the patient with a similar injury of a road accident (PsychGuides, 2020). The strong and effective preventive measure will be highly beneficial for the patient with high risk. The hospital needs to be set up, or the camp of the hospital needs to be installed in the region where such patient visits regularly. The increased concentration of the centralization of trauma care will provide an essential facility to the client to receive immediate response and the sudden discovery of injury by the others. The hospital set in the region with a high injury rate needs to be careful to focus on the client with the road accident injury (PsychGuides, 2020). The possibility of death is higher in the region, and therefore, the practitioner needs to enhance the trauma care set up by pointing the need to transform the trauma care set up more specialized and effective as it is found in the urban region.

It is also discovered here that rural region is a challenge to the principle of equality in the trauma care system. The practitioner needs to focus on the balance between the number of increasing patient from the region and the increasing risk of death and injury in a sparsely populated region. The major focus that is to be laid on by the practitioner is a physical or emotional symptom. Trauma after the accident injury is found to be manifested in the very emotion of the client (PsychGuides, 2020). The practitioners need to consider the common symptom of trauma that is anger, sadness, denial, and emotional outburst. it is also to be found that the emotion ids usually redirected towards the family members and friends, It is hard for the family or relative to manage then trauma associated with the client., The practitioners are required to manage the understanding of trauma as the family members are unable to control or manage the trauma.

Physical symptoms to be considered

The practitioners need to focus on the [physical symptoms too as trauma manifests itself emotional as well as physically (Næss, 2012). The common sign of trauma on the physic are lethargy, paleness, poor concentration, racing heartbeat. The victims are sometimes found to be incapable of coping with the situation. A physical symptom is more reseal and alarming. It is urgently required to provide proper care in a traumatic event.

Short-term and long-term

It is found that trauma persists over a long time as it requires time. It can take a few weeks or a year to leave the body. It is required to prevent any kind of effect associated with the body. Addressing trauma carefully and regularly will help in erasing the trauma in a good way and early (Kristiansen et al., 2014). Short-term trauma is similar, but long-term trauma is more though and severe to the patient. The change in the mode after short-term trauma is easier, but long-term trauma causes more impact.


The practitioners can consider the severity of the situation to use medication to manage the mental disorder. It is found that not all trauma needs medication (Næss, 2012). Anxiety and depression are common to the trauma patient and it is necessary to consider the need for counseling rather than medication and drugs (Jaremko et al., 2014).

Drug addiction

Practitioners need to verify if the trauma client is a drug addict (Jaremko et al., 2014). The road accident patients along with a history of drug addiction require to be focused to prevent them from further aggravating the situation in their trauma (Jaremko et al., 2014).

Common experience and response to trauma

It is found that a verity of reactions is found in the patient with sudden trauma due to road accidents (Liu et al., 2019). The short-term trauma manifests immediate reaction. it is found that the practitioners need to consider the fact that such clients are highly resilient and show a high degree of coping strategies involving the social supports for dealing with the effects of trauma (Liu et al., 2019). There are clients in the trauma care where they show some symptoms that do not come in diagnostics. The doctors need to consider some clients show impairment after trauma (Kristiansen et al., 2014).

Emotional deregulation

The practitioner needs to take more seriously regarding the internal behavior of the patient recover from Trauma. They have little control over anxiety, shame and sadness. IT generally happened if road accident injury occurs at an early age (Kristiansen et al., 2014). The emotional deregulation is known to be short-lived (Neumann, 2017). The patient with severe injury has deep scars on the patient, and the use of drugs along with the injury further aggravates the situation more intensely. The practitioner immediately considers the situations related to self-harm, disordered eating, overworking, gambling, or denial of emotions. Such behavior affects the patient in a larger way (Neumann, 2017).


Some clients come with their similar kind of biological disorder or move during the treatment. The practitioners need to consider the biological change that is to affect the trauma care patient (Moseme et al., 2011).

Post-traumatic disorder

As the practitioners need to focus on every kind of disorder, they are required to focus on the various disordered situation within the client. The post-traumatic disorder is to be taken seriously by the patient as the traumatic events keep coming within the mind of the victims and the severe accident will continue to affect the patient in a severe way (Moseme et al., 2011). The practitioner needs to focus on post-traumatic discovery and also manages it effectively to prevent the morbidity and mortality of the patient even after recovery from physical injury.

Traumatic stressors

The PTSD is connected with the people who have largely experienced exceptionally distressing and threatening events in the life experience. PTSD generally developed after a severely traumatic event. It can be a stressful, life-threatening event (Ponnamperuma & Nicolson, 2018). It is found that there are patients poor clients in the rural region who have experience of enhancing the stages through the imagined events. Sometimes a traumatic event is so severe that it keeps visiting the clients’ imagination aggravating his situation more intensely. The practitioner needs to consider some exceptional symptoms while treating the traumatized payment after the severe road accident injury (Ponnamperuma & Nicolson, 2018). The most affecting symptom in the trauma patient comes from the re-experiencing of the events. It includes the flashback of the patients in which the feeling and reaction of the persons are highly distressing and vivid (Kristiansen et al., 2014). The intrusive and repetitive images or the associated sensory impressions from the occurred event made it stressful for the client to forget the event and experience the high impression of the trauma. It is necessary to avoid remaining the patient regarding similar kinds of events (Moahmmadi, 2016). The patient and the relative require lying stress on the required events and situation. The practitioner needs to consul eth patient to make them avoid remembering the sad event (Kristiansen et al., 2014). The practitioner also needs to consider the sleeping issue of the client as the client failed to sleep due to the memory of the trauma event. The sleeping disorder is one of the most severe things that affect the patient largely and enhance the disorder. The difficulty in sleeping as it happened due to the memory of the event requires to be focused more controllably by the practitioners.

A secondary problem of trauma

The trauma causes severe distress to the client and the way of interfering in educational social and occupational life is largely different. It is common for the patient of trauma to have experience of job loss, re-experiencing the symptoms, and concentration of the problems of regular work and the client is found to be unable to cope with the traumatic issue (Elvik, 2016). The practitioner needs to consider the problems associated with the regular reminder of the traumatic event (Kristiansen et al., 2014). The disorder of the patient in the post-traumatic event alienates the client or sufferer from society. If there is an existence of a problem within the family, the disorder of the patient will be identified. Then the practitioner needs to focus on the counseling to reduce or avoid the family issue before the client.

Summarize the Intervention Approaches

The intervention required for the patient under trauma care after the road accident injury is of many. The intervention approaches suggested by the considered study is to enhance primary care to the patient visiting the place (CVA, 2017). Providing primary care to the trauma patient who has met a road accident is still a challenge to the health care practitioner. In order to provide primary care to the client suffered severe injury requires developing a health care system near the high-risk region. The setting up of the health care institution near the high-risk region will be beneficial to the patient as the early medical care will reduce the trauma and mortality rate. The increased mortality rate will increase the trauma of the patient at large. Pre-hospital care for trauma patients is essential, and the medical practitioners need to collaborate with the local medical system to provide essential and effective care to the patient. Pre-hospital care plays a crucial role in managing the trauma of the client in a far more effective way. The government also needs to focus on the rural region of Norway the casualties are higher (Kooda et al., 2015). The government's provision to provide the medical care facility will allow the patient to receive early care.

The emergency operating system is required to provide surgery at the early stage of injury to prevent further trauma within the patient. The delay in receiving initial treatment has largely affected the population more largely (Kristiansen et al., 2014). The study focuses on the treatment in the initial stage of injury and accident as a large number of trauma patient dies in the rural region due to lack of medical facility received at the early period.

Post-traumatic care

Post-traumatic care is not free from stress and disorder as the client is more affected with the reflection and recreation of the accident within the imagination causes immense damage to the patient in the post-trauma care period (Kristiansen et al., 2014). The patient is deeply affected and therefore requires more counseling and care rather than medicine. The society needs to extend support in the post-trauma care as the loss of job and other issues affect the patient adversely. The post-crash care is the most essential for the patient who had met a severe accident. 

The patient in road accidents requires instant discovery and instant response from the medical system for initial care to the patient. The government also needs to take the necessary step to increase the trauma patient with the formulation of an efficient traffic system. An effective and efficient traffic system will discourage the number of accidents in the rural region (Kristiansen et al., 2014). Through effective land use policy, the traffic system can be made safer and better to avoid accidental injury to the patient. The accidental injury will be reduced with the proper assessment of the traffic system (Kristiansen et al., 2014). The assessment will help to identify the risk associated with the road and the identified risks need to be reduced with the mitigating measures. The attempt is to be to reduce the number of trips on the road. The reduction of road accidents will decrease the client with road accident injury and subsequent trauma. The exposure to high-risk areas is to be reduced. The exposure to the high-risk area required a special focus from the health care system. The efficient and affordable care will be helpful to provide the best care to the patient.

Conclusion on Road Injury-Related Trauma of Norway

With the essay on the trauma-related road accident injury, it is found that the client's population analysis is necessary to understand the trauma faced by the population in general. It gave a broad understanding of the types of issues that arise and the challenges faced by the client as well as the health care providers. The health care providers provide face extreme challenges as it has been found from the study. Despite the progress in the medical system, trauma care is found to be a challenge to the health care system. Lack of an efficient system for the pre-hospital phase causes casualties and trauma among the patient. It also gave me understanding factors responsible for the rise in the road Injury related trauma. The required interventions are also focused on the study, and a good perception regarding intervention was also known with the system. The essential and pre-hospitalization care in the rural region is ineffective and it causes immense damage to the considered population. The increased focus will allow the patient to experience less trauma and unnecessary mental disorder in post-trauma care. Post-trauma care treatment enhances the client's well-being. It provides the client with a high degree of satisfaction and curability to stay away from mental disorders and anxiety.

References for Road Injury-Related Trauma of Norway

Wisborg, T., Hoylo, T., & Siem, G. (2003). Death after injury in rural Norway: high rate of mortality and prehospital death. Acta Anaesthesiologica Scandinavica47(2), 153-156. doi: 10.1034/j.1399-6576.2003.00021.x

Kristiansen, T., Lossius, H., Rehn, M., Kristensen, P., Gravseth, H., Røislien, J., & Søreide, K. (2014). Epidemiology of trauma: A population-based study of geographical risk factors for injury deaths in the working-age population of Norway. Injury45(1), 23-30. https://doi.org/10.1016/j.injury.2013.07.007

Schemitsch, C., & Nauth, A. (2019). Psychological factors and recovery from trauma. Injury. https://doi.org/10.1016/j.injury.2019.10.081

Davenport, R. (2014). Coagulopathy following major trauma hemorrhage: lytic, lethal and a lack of fibrinogen. Critical Care18(3), 151. https://doi.org/10.1186/cc13923

PsychGuides. (2020). Trauma Symptoms, Causes and Effects - PsychGuides.com. PsychGuides.com. Retrieved 30 May 2020, from https://www.psychguides.com/trauma/.

Giummarra, M., Simpson, P., & Gabbe, B. (2019). Pain, Anxiety, and Depression in the First Two Years Following Transport-Related Major Trauma: A Population-Based, Prospective Registry Cohort Study. Pain Medicine21(2), 291-307. https://doi.org/10.1093/pm/pnz209

Hubele, N., & Kennedy, K. (2018). Forward collision warning system impact. Traffic Injury Prevention19(sup2), S78-S83. https://doi.org/10.1080/15389588.2018.1490020

Næss, T. (2012). Clive’s First and Last Trip to Norway—And Something Between and After. Voices: A World Forum For Music Therapy12(2). https://doi.org/10.15845/voices.v12i2.663

Jaremko, K., Sterling, R., & Van Bockstaele, E. (2014). The impact of stress and trauma on methadone-assisted treatment and initial treatment engagement in opioid dependence recovery. Drug And Alcohol Dependence140, e96. https://doi.org/10.1016/j.drugalcdep.2014.02.279

Liu, S., Curren, J., Leahy, N., Sobocinski, K., Zambardino, D., & Shikar, M. et al. (2019). Trauma Response Nurse. Journal Of Trauma Nursing26(4), 215-220. https://doi.org/10.1097/jtn.0000000000000454

Neumann, D. (2017). Treatments for Emotional Issues After Traumatic Brain Injury. Journal Of Head Trauma Rehabilitation32(5), 283-285. https://doi.org/10.1097/htr.0000000000000337

Moseme, T., Andronikou, S., & Theron, S. (2011). Transtympanic Facial Nerve Palsy After Mountain Bike Accident. The Journal Of Trauma: Injury, Infection, And Critical Care71(4), E101. https://doi.org/10.1097/ta.0b013e31822dd21f

Ponnamperuma, T., & Nicolson, N. (2018). The Relative Impact of Traumatic Experiences and Daily Stressors on Mental Health Outcomes in Sri Lankan Adolescents. Journal Of Traumatic Stress31(4), 487-498. https://doi.org/10.1002/jts.22311

Moahmmadi, N. (2016). 532 New emerging perspectives on raod safty managment: what light can complexity science trow?. Injury Prevention22(Suppl 2), A192.1-A192. https://doi.org/10.1136/injuryprev-2016-042156.532

Elvik, R. (2016). A theoretical perspective on road safety communication campaigns. Accident Analysis & Prevention97, 292-297. https://doi.org/10.1016/j.aap.2015.04.027

CVA, K. (2017). https://www.medwinpublishers.com/JOBD/JOBD16000139.pdf. Journal Of Orthopedics & Bone Disorders1(7). https://doi.org/10.23880/jobd-16000139

Kooda, K., Aho, J., Weber, D., & Brown, A. (2015). 1149. Critical Care Medicine43, 289. https://doi.org/10.1097/01.ccm.0000474980.38145.7b

Kristiansen, T., Lossius, H. M., Rehn, M., Kristensen, P., Gravseth, H. M., Røislien, J., & Søreide, K. (2014). Epidemiology of trauma: a population-based study of geographical risk factors for injury deaths in the working-age population of Norway. Injury45(1), 23-30.

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