Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

Abstract

Background The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach. Methods Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient. Results Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness. Discussion Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.

Comparison of physical and psychological health outcomes for motorcyclists and other road users after land transport crashes: an inception cohort study

“…The extent of recovery among motorcyclists at 12-months post-injury, was significantly greater among those whose baseline mental health was better (lower baseline DASS and PCS), who reported less pain post-crash and who had shorter length of stay (implying lower injury severity). Visser et al [ 41 ] recently reported similar findings in a land transport crash cohort, where higher baseline scores for anxiety and depressive symptoms were predictive of poorer outcomes at 12 months post-crash. While Visser’s cohort included all road user types, they evaluated them as one group only, their conclusions, supported by our study findings, suggests that early screening could identify those at risk of poorer psychological outcomes.…”

Prediction and Influencing Factors of Big Data on College Students’ Positive Psychological Quality under Mobile Wireless Network

“…Visser et al [26] proposed a new psychological trajectory identification process using the latent class analysis process.…”

Comparing Health Status after Major Trauma Across Different Levels of Trauma Care

“…Injuries like amputations, multiple long bone fractures, or complex panfacial fractures result in an ISS < 15, but can heavily impact daily life and recovery trajectories. Third, patients at risk for impaired health status can be identified by symptoms of anxiety or depression, acute stress disorder, post-traumatic stress disorder, neuroticism, and trait anxiety, and in general not on sociodemographics or clinical outcome measures [43] . Fourth, level I trauma centres might not have reached their optimal volume of major trauma patients for an ideal exposure/skills and ownership/coordination ratio [44] .…”