A. Sarver1, K. Polcari1, K. Brownlee1, R. Rattan1, T. Zakrison1 1University Of Miami,Miami, FL, USA
Introduction:
Large gaps of knowledge remain in the understanding of social complications experienced by survivors of firearm violence and interventions that could be employed to reduce its incidence. Little is known about the perceptions of trauma care providers about their understanding of a firearm violence survivor’s experience – especially at different stages of trauma care. This is important as trauma providers frequently inform the creation of firearm-related injury prevention programs. The objective of this study is to understand these perceptions of trauma providers about the causes of firearm violence in our community of South Florida and furthermore assess their thoughts regarding the experience of firearm violence for their gunshot wound patients.
Methods:
We used a mixed methods approach to triangulate both qualitative and quantitative results. Qualitatively, we performed individual interviews with semi-structured, open ended questions. Participants were trauma surgeons and trauma anesthesiologists working at a high volume, Level 1 trauma center that sees a significant rate of firearm-related violence. Participants were identified using a snowballing sampling technique. Interviews continued until thematic saturation occurred. Grounded theory methodology was employed to build theory from salient themes. Observational data was incorporated from interviews with participants. Quantitative data included similar, survey-type questions with results quantified using Likert scales.
Results:
A total of 12 trauma providers were interviewed over a three month period. The immediate experience of gun violence was interpreted as having a fear of dying, confusion and desire for revenge. The initial resuscitation of these patients was felt to be dehumanizing at times while the impact of injury was devastating to families, emotionally and economically. Young low-income Black males are disproportionately affected in Miami, yet gun violence was reiterated to affect all. Socio-demographic inequality was identified by all providers as a major reason for violence with gun control having mixed responses. Hospital-based injury prevention programs are supported by providers, with leadership of such programs emanating from the communities. Overall observations showed that many of the providers spoke from a place of detachment, and cultural incompetence. Many of the ideas reflected a misunderstanding or unwillingness to recognize gun violence as a complex system of targeted oppression. Quantitative analysis demonstrated similar findings.
Conclusion:
Firearm violence is identified by most trauma care providers as rooted in social inequality. The role of gun control is mixed. While the experience of being injured by firearm violence is identified as a deeply frightening for both patient and family, there is a disconnect between the perceptions of trauma care providers and possibly with patients. This merits further exploration for formal comparison.