Posttraumatic Concerns: A Patient-Centered Approach to Outcome Assessment After Traumatic Physical Injury

Abstract

The concerns of physically injured trauma survivors are readily elicited and followed up during the course of the year after injury. Open-ended inquiry regarding posttraumatic concerns may complement standardized outcome assessments by identifying and contextualizing the outcomes of greatest importance to patients.

Indicators of injury recovery identified by patients, family members and clinicians

“…This echoes one element of findings by Clay and colleagues 31 where more severely injured workers changed their expectations about their recovery timeframe; as well as the finding by Zatzick and colleagues that patient concerns gradually reduced over time 14 . Changes in priorities and expectations over time has implications for the provision of both education and support, with these needing to be available and relevant at different phases in the recovery trajectory.…”

“…When examined, significant differences in recovery preferences and perceptions have been identified, with patients placing greater value on activities of daily living such as eating, bathing and toileting while clinicians valued cognitive activities such as expression, comprehension and memory 11 or with patients and relatives perceiving greater compromise than clinicians 12 . Further, there is evidence that indicators of successful recovery change over time with the number of concerns being greatest 1 to 4 weeks after hospital discharge, and focusing on practical issues at this time 13,14 .…”

Implementing assessments via mobile during the acute posttrauma period: feasibility, acceptability and strategies to improve response rates

“…A key challenge in developing such strategies has been a lack of knowledge about how such disorders develop during the acute posttrauma period. There are considerable demands on trauma victims at this time such that participation in research during this period is difficult (Zatzick et al, 2001). Solutions that allow researchers and clinicians to interact with victims during this period in an unobtrusive manner are needed.…”

Collaborative Care Interventions in General Trauma Patients

“…15,31,36,39,45 Commonly expressed patient concerns at the time of hospital discharge include physical, financial, and social concerns and these can interrupt the focus on post-injury psychiatric care. 53 Intervention protocols that assist patients in addressing these concerns appear to allow patients to focus more on any needed psychiatric treatment. 53,51 …”

“…53 Intervention protocols that assist patients in addressing these concerns appear to allow patients to focus more on any needed psychiatric treatment. 53,51 …”