The impact of psychological factors on recovery from injury: a multicentre cohort study

Abstract

PurposeUnintentional injuries have a significant long-term health impact in working age adults. Depression, anxiety and post-traumatic stress disorder are common post-injury, but their impact on self-reported recovery has not been investigated in general injury populations. This study investigated the role of psychological predictors 1 month post-injury in subsequent self-reported recovery from injury in working-aged adults.MethodsA multicentre cohort study was conducted of 668 unintentionally injured adults admitted to five UK hospitals followed up at 1, 2, 4 and 12 months post-injury. Logistic regression explored relationships between psychological morbidity 1 month post-injury and self-reported recovery 12 months post-injury, adjusting for health, demographic, injury and socio-legal factors. Multiple imputations were used to impute missing values.ResultsA total of 668 adults participated at baseline, 77% followed up at 1 month and 63% at 12 months, of whom 383 (57%) were included in the main analysis. Multiple imputation analysis included all 668 participants. Increasing levels of depression scores and increasing levels of pain at 1 month and an increasing number of nights in hospital were associated with significantly reduced odds of recovery at 12 months, adjusting for age, sex, centre, employment and deprivation. The findings were similar in the multiple imputation analysis, except that pain had borderline statistical significance.ConclusionsDepression 1 month post-injury is an important predictor of recovery, but other factors, especially pain and nights spent in hospital, also predict recovery. Identifying and managing depression and providing adequate pain control are essential in clinical care post-injury.Electronic supplementary materialThe online version of this article (doi:10.1007/s00127-016-1299-z) contains supplementary material, which is available to authorized users.

Differential Predictors of Pain Severity Over 12 Months Following Noncatastrophic Injury Sustained in a Road Traffic Crash

“…patients better manage these conditions as well as timely referral to appropriate services as necessary. 23,24 In our cohort, higher OMPSQ scores at baseline was an independent predictor of higher pain ratings during the 12 month follow-up. This is plausible as the OMPSQ has been promoted as a tool to screen for psychosocial risk factors associated with delayed recovery; and a recent systematic review 18,27 showed that the OMPSQ has reasonable or moderate predictive ability in identifying persons at risk of developing chronic pain.…”

“…36 It is important to note, however, that healthcare professionals routinely treating people with mild/ moderate injuries are not mental health experts. 24 Hence, one judicious clinical implication of this study would be that non-mental health professionals be trained to identify patients at risk of poor recovery using brief self-report measures of psychological health and pain, so as to help…”

Impact Of Wounds In The Assistance To Basic Human Needs In Intensive Care

“…Patients report anxiety, sadness and discouragement, even depression. This shows that emotional distress is caused by the ICU, which instigates and strengthens feelings of negativity [17][18]7]. When these feeling are associated with the presence of wounds, major effects on the customer coping ability are seen, once weakened by the peculiarities of this sector.…”

“…This is due to anxiety related to the treatment and delay in the evolution of wound healing. This can lead to depression because the damage is not only physical, but a stigma resonates in interpersonal and family relationships [5,[6][7].…”

Prevalence of serious mental illness and mental health service use after a workplace injury: a longitudinal study of workers’ compensation claimants in Victoria, Australia

“…Workers who have experienced a physical workplace injury are at high risk of developing secondary mental health conditions: recent data suggest that up to half develop depressive symptoms within a year of injury 1 2. Secondary mental health problems negatively impact long-term recovery and return to work (RTW) 3 4. Therefore, there is a strong need for consistent and effective mental health screening, referral and treatment among those experiencing occupational injuries, yet it is not clear whether this need is being met.…”