Quality of life in severely injured patients depends on psychosocial factors rather than on severity or type of injury

Delft-Schreurs, C.C.H.M. van; Bergen, Jenny; Jongh, Mariska A. C. de; Sande, Peter van de; Verhofstad, M.H.J.; Vries, Jolanda De

doi:10.1016/j.injury.2013.02.025

Cited by 55 publications

(56 citation statements)

References 36 publications

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“…Patients who cannot regain their previous job or become unemployed may experience lower QOL, but it is also possible that patients with decreased QOL need more time to return to work. Age and ISS were not related to QOL in our study population, 24 although older patients and more severely injured patients reported more physical limitations. Older patients may have accepted their physical limitations easier because they might be used to the expectation of physical limitations due to ageing.…”

Section: Discussioncontrasting

confidence: 50%

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The relationship between physical and psychological complaints and quality of life in severely injured patients

Delft-Schreurs

Son²,

Jongh

et al. 2017

Injury

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Purpose: The purpose of this study was two-fold. The first goal was to investigate which variables were associated with the remaining physical limitations of severely injured patients after the initial rehabilitation phase. Second, we investigated whether physical limitations were attributable to the association between psychological complaints and quality of life in this patient group. Differences in physical limitations were investigated for several trauma-and patient-related variables using non-parametric independent-sample Mann-Whitney U tests. Multiple linear regression was performed to investigate whether the decreased QOL of severely injured patients with psychological complaints could be explained by their physical limitations. Results:Older patients, patients with physical complaints before the injury, patients with higher ISS scores, and patients who had an injury of the spine or of the lower extremities reported significantly more physical problems. Additionally, patients with a low education level, patients who were living alone, and those who were unemployed reported significantly more long-term physical problems.Severely injured patients without psychological complaints reported significantly less physical limitations than those with psychological complaints. The SMFA factor of Lower extremity dysfunction was a confounder of the association between psychological complaints and QOL in all QOL domains.Conclusions: Long-term physical limitations were mainly reported by patients with psychological complaints. The decreased QOL of severely injured patients with psychological complaints can partially be explained by physical limitations, particularly those involving lower extremity function. Experienced physical limitations were significantly different for some trauma and patient characteristics. These characteristics may be used to select patients for whom a rehabilitation programme would be useful.

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Section: Discussioncontrasting

confidence: 50%

“…The mean time since the injury was 2.8 (SD 0.9) years. Most patients were males (69%), with a mean age of 46 (SD 19) years and a median ISS of 21 (interquartile range [17][18][19][20][21][22][23][24][25][26][27]. The most common injury was intracranial injury (61%), and 86% of the patients had received ICU treatment (table 1).…”

Section: Patientsmentioning

confidence: 99%

The relationship between physical and psychological complaints and quality of life in severely injured patients

Delft-Schreurs

Son²,

Jongh

et al. 2017

Injury

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“…In a former study, injury type, age, gender, length of hospital stay, intensive care unit (ICU) days, injury severity, post-traumatic stress symptoms and return to work were found to be associated with functional outcome and recovery 25 26. Furthermore, important determinants of long-term disability after trauma are patients with one or more comorbidities,29 patients with multiple injuries30 and frailty in elderly patients 31 32…”

Section: Introductionmentioning

confidence: 99%

Prevalence, recovery patterns and predictors of quality of life and costs after non-fatal injury: the Brabant Injury Outcome Surveillance (BIOS) study

et al. 2016

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“…Furthermore, pain was found to be a major predictor for psychological adjustment problems two years after injury 16 . ASD, PTSD, and psychological distress are positively associated with wound healing and fatigue 13,[20][21][22][23][24][25] and negatively with quality of life (QOL) compared to the general population 18,[26][27][28][29][30][31] . Also, patients' satisfaction with work status, general health, and recovery from injury are related with impaired mental health, depressive symptoms, and increased risk of substance abuse 30,32 .…”

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confidence: 99%

“…Psychosocial problems and disorders can have a negative impact on patients' lives up to years later 13,[16][17][18] . For instance, 45% of the patients could not pursue with leisure activities and 27% reported a broken marriage six years after trauma 19 .…”

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confidence: 99%

Physical Trauma Patients with Symptoms of an Acute and Posttraumatic Stress Disorder: Protocol for an Observational Prospective Cohort Study (Preprint)

Visser¹,

Gosens²,

Oudsten³

et al. 2017

Preprint

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Psychological trauma can be divided into Type-I trauma (i.e. one single traumatic event (e.g. car accident)) and Type-II trauma (i.e. repeated and prolonged traumatization (e.g. abuse)). Physical trauma or injury is a Type-I trauma and a major source of high medical and social costs 1 . In the Netherlands, injury is the leading cause of death for persons younger than 35 years old 2 .Due to registration and implementation of specialized trauma care after injury, the quality of trauma care has been improved and survivorship increased [1][2][3][4][5][6] . However, patients go through a process of treatment after injury: from the ambulance or trauma helicopter to the shock room, possible hospital stay, and finally rehabilitation. The treatment in, for example, the shock room can be impressive and can have a major impact on patients' wellbeing. About 43% to 84% of the patients experience psychological problems (e.g. anxiety, depressive symptoms or opioid abuse) 7-10 and 7% has psychiatric comorbidity after physical trauma 11 . About 25% of the trauma patients have an (subsyndromal) acute stress disorder (ASD) during hospitalization and about 30% had post-traumatic stress disorder (PTSD) one month after injury 12,13 . About 49% showed a delayed onset of PTSD six months after injury. This percentage decreased to 20% at 24 months after injury 13 . Diagnostic criteria for ASD and PTSD are similar with regard to re-experiencing (e.g. flashbacks), increased arousal (e.g. difficulty concentrating), and persistent avoidance (e.g. efforts to avoid thoughts, feelings or places associated with the trauma). However, dissociative symptoms (e.g., numbing, reduction in awareness of surroundings, depersonalization, derealization, and/or dissociative amnesia) are emphasized in ASD, while PTSD does not include dissociative symptoms. Moreover, the diagnosis ASD can only be given within the first month after a traumatic event and last for less than a month. If the symptoms continue longer than a month, a diagnosis of PTSD is given. The symptoms may begin either after trauma or months or years afterwards 14 . PTSD symptoms persist for at least one month after injury 15 .Psychosocial problems and disorders can have a negative impact on patients' lives up to years later 13,[16][17][18] . For instance, 45% of the patients could not pursue with leisure activities and 27% reported a broken marriage six years after trauma 19 . Furthermore, pain was found to be a major predictor for psychological adjustment problems two years after injury 16 . ASD, PTSD, and psychological distress are positively associated with wound healing and fatigue 13,[20][21][22][23][24][25] and negatively with quality of life (QOL) compared to the general population 18,[26][27][28][29][30][31] . Also, patients' satisfaction with work status, general health, and recovery from injury are related with impaired mental health, depressive symptoms, and increased risk of substance abuse 30,32 . As a result, the costs of care increases due to patients who needs more medical care...

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Quality of life in severely injured patients depends on psychosocial factors rather than on severity or type of injury

Cited by 55 publications

References 36 publications

The relationship between physical and psychological complaints and quality of life in severely injured patients

The relationship between physical and psychological complaints and quality of life in severely injured patients

Prevalence, recovery patterns and predictors of quality of life and costs after non-fatal injury: the Brabant Injury Outcome Surveillance (BIOS) study

Physical Trauma Patients with Symptoms of an Acute and Posttraumatic Stress Disorder: Protocol for an Observational Prospective Cohort Study (Preprint)

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