# Enhancing Patient Education through a 'Journey Guide' For Adult Traumatic Brachia! Plexus Injury

> **NIH NIH R03** · WASHINGTON UNIVERSITY · 2022 · $78,750

## Abstract

ABSTRACT
In a brachial plexus injury (BPI), the nerves connecting the spinal cord to the shoulder, arm, and hand are
damaged, leading to searing pain, loss of muscle function, and lack of sensation. Historically, prognosis after
BPI has been associated with severity of the nerve injury (how many portions of the brachial plexus are involved).
However, recent research from our group and others have demonstrated that other factors may influence
outcomes and quality of life. In our K23 work, we are interviewing BPI patients and surgeons to understand the
role of these psychosocial and emotional factors on recovery after surgery. Our preliminary qualitative analysis
demonstrates that patients desire more effective counseling about realistic functional outcomes, emotional
aspects of recovery, and how to deal with the severe neuropathic pain that accompanies BPI. Patients also want
more insight into the rationale for certain decisions made by the surgeons caring for them, such as timing and
type of surgical intervention. These domains serve as points of dissatisfaction for patients, and we see them as
opportunities for designing an intervention for educating and empowering patients, with the ultimate goal of
increasing their satisfaction with the recovery process. Based on these findings, we propose that interventions
that improve patient engagement, knowledge of the condition, and understanding of the treatment plan will lead
to discrete and measurable improvements in satisfaction and functional recovery after reconstructive BPI
surgery. To this end, we will use the K23 interview data to develop a BPI journey guide, in which we will address
the domains identified by K23 participants as gaps in knowledge (such as physical and emotional aspects of
recovery; expectation setting for functional outcomes; pain management; communication with the healthcare
team; and caregiver needs). We will follow best practices of health literacy and plain language to ensure that the
journey guide is understandable for patients. We will collaborate with a BPI patient advocacy organization (United
Brachial Plexus Network) to have patient volunteers grade the acceptability of the journey guide (Aim 1). We will
ask BPI surgeons, physiatrists, hand therapists, nurses and social workers to evaluate the acceptability and
accuracy of the journey guide (Aim 2). The result of this work will be an education tool that can be used
immediately in clinical practice and widely distributed to BPI patients and health care providers. Furthermore, we
plan to submit a future R01 proposal to examine the effectiveness of this to evaluate the effectiveness of a suite
of interventions (including the journey guide) geared to maximize patient quality of life and satisfaction after BPI.

## Key facts

- **NIH application ID:** 10433825
- **Project number:** 5R03AR077109-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Christopher John Dy
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $78,750
- **Award type:** 5
- **Project period:** 2021-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10433825

## Citation

> US National Institutes of Health, RePORTER application 10433825, Enhancing Patient Education through a 'Journey Guide' For Adult Traumatic Brachia! Plexus Injury (5R03AR077109-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10433825. Licensed CC0.

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