Major farm-related injury in Victoria · DEAKIN UNIVERSITY CRICOS PROVIDER CODE: 00113B Major farm-related injury in Victoria: Farmers’ perspectives on recovery. Jessica Beattie

DEAKIN UNIVERSITY CRICOS PROVIDER CODE: 00113B

Major farm-related injury in Victoria: Farmers’ perspectives on recovery.

Jessica Beattie1, Meg Murray1, Daryl Pedler1, Candis McLeod1, Susan Brumby2 and Belinda Gabbe3

1 Rural Community Clinical School, Deakin University 2 National Centre for Farmer Health, Deakin University and Western District

Health Service3 Department of Epidemiology and Preventive Medicine, Monash University

Background


➢ The agriculture industry makes up 2.3% of the Australian workforce but accounts for 23% of worker fatalities.

➢ 56.4 farm injuries per 1000 workers.

➢ Economic cost of farm injury (2012-2013) was 1.2 billion dollars p.a. equating to $133,170 per injury.

SOURCE: Traumatic Injury Fatalities database and National Data Set for

Compensation-Based Statistics, Safe Work Australia 2017

Research Aims


1. Investigate farmers experiences with recovery following major farm-

related injury.

2. Identify the barriers and enablers to recovery following a major farm-

related injury.

Methodology: Participants


Patients registered on the Victorian State Trauma Registry (VSTR).

Inclusion criteria:

➢ Aged 18 years or over at the time of the incident, and

➢ Sustained a trauma incident between 2007 - 2013 in Victoria, and

➢ Were injured on a farm (but not in a farm house), and

➢ Were able to participate directly in the interview (patients with

cognitive deficits and a primary language other than English were

excluded).

Methodology: Recruitment


323 participants contacted by

VSTORM

24 returned letters

13 participants were not

interviewed

61 participants contacted Deakin Research team

12 declined to participate

36 participants interviewed

3 interviews discarded due to not being a farm-

related injury

FINAL sample size: 33

25 farm owners6 farm workers2 bystanders

Methodology: Data collection


TOPIC INTERVIEWER PROMPTS

Injury • Describe incident

• Injuries sustained

Recovery • What happened once you left

hospital/rehabilitation

Farming • Role on the farm prior to injury

• Role on the farm changed since injury

• Farming future

Safety • Attitudes to farm safety post injury

• Safety changes implemented post injury


➢ Thematic analysis was conducted on the data.

➢ Common themes were identified and a thematic framework was

developed.

➢ Data collection and analysis continued until data saturation had been

achieved.

QUALITATIVE ANALYSIS

Demographics snapshot

Study participants

➢ Median (IQR) age (years) 58 (50-63)

➢ Male 82%, Female 18%

➢ Median (IQR) Injury Severity Score (ISS) and range 18 (14-24)

➢ Discharge to home 52%

➢ Cause of injury: Other animal ‘cattle’ 24% Horse related 21%Motor bike crash 21%

VSTR farm injury cohort

➢ Median (IQR) age (years) 51 (37-61)

➢ Male 81%, Female 19%

➢ Median (IQR) Injury Severity Score (ISS) and range 16 (13-21)

➢ Discharge to home 59%

➢ Cause of injury: Motor bike crash 28% Horse related 26%Other 24%


Results: Immediate care


(Male, injured by cattle, multiple fractures)

Satisfaction and gratitude with medical expertise and care.

“I couldn’t speak highly of them... enough. They are just fantastic. The nurses are all dedicated. The doctors are outstanding and all the administration are marvellous.”

“It was interesting. One is that as a public patient, I ended up with Australia’s top pelvic fracture surgeon who did the work on putting me back together. And so I couldn’t have got better surgical care, if I tried, or I paid a million dollars for it.”

(Male, quad bike, multiple fractures)

Results: Hospital discharge


(Male, quad bike, multiplefractures)

Communication, listening and lack of involvement in decision making process

“I got home on Saturday afternoon and then got

through Sunday, like death warmed up, and then

Monday morning we went into the doctor…He took one look at me and said

we’re putting you straight in.”

“I was kicked out of hospital about three days later I think it was… I’m thinking if it was time for me to go, well, it’s time for

me to go, but I could barely walk. So I could understand that had they given me

an option for a couple more days I probably would have taken it….. But they

were desperate for beds.”

(Male, other, internal injuries)

Results: Access to ambulatory care


(Female, injured by cattle, fracture vertebrae)

(Male, injured by cattle, brain injury/ multiple fractures)

Referrals, organisation of care, distance and availability of services.

“We had to do a lot of travelling to see doctors, backwards and forwards to Melbourne, which was pretty hard at the time.”

“For one, I didn’t know what I was entitled to at any stage. I kind of just stumbled across it. And I wouldn’t be surprised if I had a look now I would have been entitled to a lot more help along the way.“


Figure 2: Geographical areas where farm injuries were sustained

Results: Impact on farming


(Male, fall from farming structure,multiple fractures)

(Male, injured by cattle, brain injury)

Loss of production, sale of the farm, changes to farming practices, safety.

“Well, it sort of went to waste (grain crop). Everyone else at that particular point of the year was flat out doing other things. I did get help but it went to waste, it was very unfortunate.”(Male, fall from farming structure, multiple fractures).

“Yeah, I had to sell the farm; I couldn’t cope with it anymore. I also developed depression and anxiety and that sort of stuff.”

Results: Impact on farming (Cont.)


(Male, quad bike accident, brain injury)(Male, fall from farm structure, multiple

fractures)

Loss of production, sale of the farm, changes to farming practices, safety.

“..after the accident I can remember, nearly every

four-wheeler being ridden around farms in the area,

the riders more often than not had helmets, and

previous to that no-one wore helmets.”

“Well, locally, there are probably a dozen farmers around here that have put

automatic closing lids in their silos so they don’t have to get up there. And

those same blokes have all bought safety harnesses.”

Results: Psychological Impact


(Female, fall from horse, fractured vertebrae)

(Male, fall from horse, multiple fractures)

Independence, traumatic thoughts, positive attitude, impact on family.

“Grieving the loss of your life you used to have….I feelembarrassed.”

“I just had a mental replay of the whole incident,which went round my mind endlessly, every wakinghour.”

Results: Insurance providers


(Male, injured by cattle, brain injury/ multiple fractures)

(Male, injured by horse, multiple fractures)

Frustration, communication, advocacy and gratitude.

“I had trouble with WorkCover,being able to get into the caresometimes, to get the approval todo it – that was always a majorissue.”

“Once it was discovered I hadprivate health cover it was awhole different ballgame.Things started happening fairlyquickly then.”

Conclusions: Health care and Education


➢ Improvement to the hospital discharge process by the involvement of farmers

in the decision making process.

➢ Use of telehealth services between farmers, and metropolitan health care

providers for follow up appointments to reduce the travel burden and increase

access.

➢ Improve the coordination of care between tertiary hospital and rural health

services to ensure farmers have timely access to ambulatory support services

and equipment.


Conclusions: Health care and Education (Cont.)

➢ Specific education is required to up skill health care professionals working

with farmers who have sustained a farm-related serious injury. This is

especially important when patients are returning to recover on the farm.

➢ Further education for farmers about income protection insurance and

Worksafe requirements.

Conclusions: Agricultural Services


➢ Professional support or advice on how the farm will be managed during the

recovery phase, is warranted from a farm management and health and

safety perspective.

➢ Engagement of farmers who have sustained a major farm-related injury as

advocates and educators for farm safety.

➢ Professional support services to address the needs of aging farmers and

implementation of practices that allow them to physically continue farming

and/or develop succession planning.

Acknowledgements


We would like to thank:

➢ The participants who generously gave their time to share their experiences.

➢ Western Alliance for funding the project.

➢ VSTORM for supporting the project and providing access to the VSTR data.

➢ National Centre for Farmer Health for support and guidance.

Further information:

Jessica Beattie,Rural Community Clinical School,Deakin University,Email: [email protected]

Documents

Major farm-related injury in Victoria · DEAKIN UNIVERSITY CRICOS PROVIDER CODE: 00113B Major farm-related injury in Victoria: Farmers’ perspectives on recovery. Jessica Beattie