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Conrad EJ, Hansel TC, Pejic NG, Constans J. Assessment of Psychiatric Symptoms at a Level I Trauma Center Surgery Follow-up Clinic: A Preliminary Report. Am Surg 2020. [DOI: 10.1177/000313481307900524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
At Level I trauma centers, psychiatric consultation is readily available to inpatient surgical services. This study sought to characterize the psychiatric symptoms present in the surgical follow-up clinic. Patients aged 18 years and older were assessed over one month for symptoms of posttraumatic stress disorder (PTSD) with the Short PTSD Rating Interview (SPRINT), depression with the Patient Health Questionnaire (PHQ-9), alcohol abuse with the Alcohol Use Disorder Identification Test (AUDIT), and the presence of violence using the MacArthur Community Violence Instrument (MCVIa [victimization] MCVIb [perpetration]). Twenty-five individuals participated. Using the SPRINT, 13 (52.0%) met the cutoff for PTSD. For PHQ-9 depression, 11 (44%) were in the moderate to severe range. For AUDIT, five (20.0%) likely had an alcohol problem. Using the MCVI, 15 (60.0%) reported victimization and 12 (48.0%) reported perpetration. Elevated levels of psychiatric symptoms were found in the trauma surgery follow-up clinic. Psychiatric care embedded in this setting may be warranted.
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Affiliation(s)
- Erich J. Conrad
- Department of Psychiatry, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Tonya C. Hansel
- Department of Psychiatry, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Nicholas G. Pejic
- Department of Psychiatry, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Joseph Constans
- Department of Psychiatry, Louisiana State University School of Medicine, New Orleans, Louisiana
- Southeast Louisiana Veterans Health Care System, South Central VA Mental Illness Research, Education, and Clinical Center, New Orleans, Louisiana
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de Munter L, Polinder S, Haagsma JA, Kruithof N, van de Ree CL, Steyerberg EW, de Jongh M. Prevalence and Prognostic Factors for Psychological Distress After Trauma. Arch Phys Med Rehabil 2020; 101:877-884. [DOI: 10.1016/j.apmr.2019.10.196] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/26/2022]
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Balasubramanian U, Krehula C, Bowe S, Sutherland AG. Patient resilience is a strong predictor of satisfaction after orthopaedic treatment. ANZ J Surg 2019; 89:11-12. [DOI: 10.1111/ans.14876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/31/2018] [Accepted: 08/19/2018] [Indexed: 11/26/2022]
Affiliation(s)
| | - Charmaine Krehula
- Department of Orthopaedics; Southwest Healthcare Warrnambool; Warrnambool Victoria Australia
| | - Steven Bowe
- Biostatistics Unit; Deakin University; Melbourne Victoria Australia
| | - Alasdair G. Sutherland
- Department of Orthopaedics; Southwest Healthcare Warrnambool; Warrnambool Victoria Australia
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van Delft-Schreurs CCHM, van Son MAC, de Jongh MAC, Lansink KWW, de Vries J, Verhofstad MHJ. The relationship between physical and psychological complaints and quality of life in severely injured patients. Injury 2017; 48:1978-1984. [PMID: 28551050 DOI: 10.1016/j.injury.2017.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/21/2017] [Accepted: 05/05/2017] [Indexed: 02/02/2023]
Abstract
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. METHODS Patients who were 18 years or older and who had an injury severity score (ISS)>15 completed a set of questionnaires at one time-point after their rehabilitation phase (15-53 months after their trauma). The Short Musculoskeletal Function Assessment (SMFA) questionnaire was used to determine physical limitations. The Hospital Anxiety and Depression Scale, the Dutch Impact of Event Scale and the Cognitive Failure Questionnaire were used to determine psychological complaints, and the World Health Organization Quality of Life assessment instrument-BREF was used to measure general Quality of Life (QOL). 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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Affiliation(s)
| | - M A C van Son
- The Netherlands Society of Occupational Medicine-Centre of Excellence, The Netherlands.
| | - M A C de Jongh
- Network Emergency Care Brabant, Elisabeth-TweeSteden Hospital, The Netherlands.
| | - K W W Lansink
- Network Emergency Care Brabant, Elisabeth-TweeSteden Hospital, The Netherlands; Department of Surgery, Elisabeth-TweeSteden Hospital, The Netherlands.
| | - J de Vries
- Department of Medical Psychology, Elisabeth-TweeSteden Hospital, The Netherlands; CoRPS, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
| | - M H J Verhofstad
- Department of Trauma Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
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Resnik L, Borgia M, Silver B. Measuring Community Integration in Persons With Limb Trauma and Amputation: A Systematic Review. Arch Phys Med Rehabil 2017; 98:561-580.e8. [DOI: 10.1016/j.apmr.2016.08.463] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/04/2016] [Accepted: 08/10/2016] [Indexed: 10/21/2022]
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de Jongh MAC, Kruithof N, Gosens T, van de Ree CLP, de Munter L, Brouwers L, Polinder S, Lansink KWW. Prevalence, recovery patterns and predictors of quality of life and costs after non-fatal injury: the Brabant Injury Outcome Surveillance (BIOS) study. Inj Prev 2016; 23:59. [PMID: 27154507 DOI: 10.1136/injuryprev-2016-042032] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 03/15/2016] [Accepted: 04/02/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Trauma is a major public health problem worldwide that leads to high medical and societal costs. Overall, improved understanding of the full spectrum of the societal impact and burden of injury is needed. The main purpose of the Brabant Injury Outcome Surveillance (BIOS) study is to provide insight into prevalence, predictors and recovery patterns of short-term and long-term health-related quality of life (HRQoL) and costs after injury. MATERIALS AND METHODS This is a prospective, observational, follow-up cohort study in which HRQoL, psychological, social and functional outcome, and costs after trauma will be assessed during 24 months follow-up within injured patients admitted in 1 of 10 hospitals in the county Noord-Brabant, the Netherlands. Data will be collected by self-reported questionnaires at 1 week (including preinjury assessment), and 1, 3, 6, 12 and 24 months after injury. If patients are not capable of filling out the questionnaires, proxies will be asked to participate. Also, information about mechanism and severity of injury, comorbidity and indirect and direct costs will be collected. Mixed models will be used to examine the course of HRQoL, functional and psychological outcome, costs over time and between different groups, and to identify predictors for poor or good outcome. RELEVANCE This study should make a substantial contribution to the international collaborative effort to assess the societal impact and burden of injuries more accurately. The BIOS results will also be used to develop an outcome prediction model for outcome evaluation including, besides the classic fatal, non-fatal outcome. TRIAL REGISTRATION NUMBER NCT02508675.
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Affiliation(s)
- M A C de Jongh
- Department Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.,Network Emergency Care Brabant, Brabant Trauma Registry, The Netherlands
| | - N Kruithof
- Department Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - T Gosens
- Department Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.,Department of Orthopaedics, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - C L P van de Ree
- Department Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - L de Munter
- Department Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - L Brouwers
- Network Emergency Care Brabant, Brabant Trauma Registry, The Netherlands
| | - S Polinder
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - K W W Lansink
- Department Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.,Network Emergency Care Brabant, Brabant Trauma Registry, The Netherlands.,Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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Sutherland AG, Senthilkumaran S, Alexander DA, Hutchison JD. If a trauma patient is tachycardic, should we call for a counsellor? Scott Med J 2016; 61:26-31. [PMID: 26721641 DOI: 10.1177/0036933015619315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It has been suggested in the literature that raised heart rate in the early period after trauma is associated with the development of post-traumatic psychopathology, but little account has been taken of the potential confounding effect of injury severity. MATERIALS AND METHODS A cohort of 154 patients, studied as part of a wider investigation of trauma outcomes, was included. Initial heart rate in the accident & emergency department, and injury severity score and new injury severity scores were recorded. Patients completed the General Health Questionnaire (GHQ-28) as a measure of psychopathology at presentation and again at two- and six-month follow-up. RESULTS There was no relationship between psychopathology at presentation and initial heart rate or injury severity. Raised heart rate was associated with post-traumatic psychopathology at two months but not at six months. When the potential confounding effect of injury severity was controlled for, there was no independent correlation between heart rate and post-traumatic psychopathology. Injury severity score and new injury severity scores were strongly associated with GHQ-28 caseness. CONCLUSION Post-traumatic tachycardia is not associated with development of psychopathology, but injury severity is. Previous studies that have suggested a link between tachycardia and development of psychopathology are flawed because they have not considered the confounding effect of severity of injury.
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Affiliation(s)
- A G Sutherland
- Formerly Senior Lecturer in Orthopaedics, Department of Orthopaedics, University of Aberdeen, UK
| | - S Senthilkumaran
- Medical Student, Department of Orthopaedics, University of Aberdeen, UK
| | - D A Alexander
- Professor of Mental Health, Aberdeen Centre for Trauma Research, Robert Gordon University, UK
| | - J D Hutchison
- Professor of Orthopaedics, Department of Orthopaedics, University of Aberdeen, UK
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Prevalence of clinical anxiety, clinical depression and associated risk factors in chinese young and middle-aged patients with osteonecrosis of the femoral head. PLoS One 2015; 10:e0120234. [PMID: 25789850 PMCID: PMC4366265 DOI: 10.1371/journal.pone.0120234] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/28/2015] [Indexed: 01/06/2023] Open
Abstract
Objective To investigate the prevalence of clinical anxiety and clinical depression in Chinese young and mid-aged patients with osteonecrosis of the femoral head (ONFH) and to analyze their potential risk factors. Methods Two hundred and sixteen Chinese patients with ONFH were consecutively enrolled in this cross-sectional study from January 2010 to December 2010. The Zung self-rating anxiety scale (SAS) and the Zung self-rating depression scale (SDS) were used to assess the prevalence of clinical anxiety and clinical depression. An additional questionnaire containing seventeen items of potential risk factors was completed by all patients. Binary logistic regression analysis was employed to reveal potential risk factors of anxiety and depression. Results The prevalence of clinical anxiety and clinical depression was 20.4% and 21.8% in Chinese young and middle-aged patients with ONFH, respectively. Binary regression analysis showed that independent risk factors correlated with high incidence of clinical anxiety included involved femoral head (OR = 3.168, 95% CI: 1.496 - 6.708) and stages of ONFH (ORIV-V / II = 5.383, 95% CI: 1.664-17.416). Independent risk factors correlated with high incidence of depression included gender (OR = 2.853, 95% CI: 1.467-5.778), comorbid diseases (OR = 4.243, 95% CI: 1.940-9.278) and stages of the disease (OR IV-V/II = 16.963, 95% CI: 4.404-65.331). Conclusions Patients with bilateral ONFH are inclined to have clinical anxiety, while female patients and patients with comorbid diseases might tend to get clinical depression. Advanced stages of ONFH are independent risk factors for both clinical anxiety and clinical depression.
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Hoffman K, Cole E, Playford ED, Grill E, Soberg HL, Brohi K. Health outcome after major trauma: what are we measuring? PLoS One 2014; 9:e103082. [PMID: 25051353 PMCID: PMC4106876 DOI: 10.1371/journal.pone.0103082] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/25/2014] [Indexed: 11/19/2022] Open
Abstract
Importance Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. Objective To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. Data Sources MEDLINE, EMBASE, and CINAHL (from 2006–2012) were searched for studies evaluating health outcome after traumatic injuries. Study selection and data extraction Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. Results 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Conclusion Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.
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Affiliation(s)
- Karen Hoffman
- Centre for Trauma Sciences, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- * E-mail: (KH); (KB)
| | - Elaine Cole
- Centre for Trauma Sciences, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - E. Diane Playford
- University College London (UCL) institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Eva Grill
- Ludwig-Maximilians-Universität Munich, Institute for Medical Informatics, Biometry and Epidemiology (IBE), Munich, Germany
| | - Helene L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Karim Brohi
- Centre for Trauma Sciences, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- * E-mail: (KH); (KB)
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van Delft-Schreurs CCHM, van Bergen JJM, van de Sande P, Verhofstad MHJ, de Vries J, de Jongh MAC. A cross-sectional study of psychological complaints and quality of life in severely injured patients. Qual Life Res 2013; 23:1353-62. [PMID: 24202637 DOI: 10.1007/s11136-013-0546-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine the incidence of psychological complaints and the relationship of these complaints with the quality of life (QOL) and accident- and patient-related factors among severely injured patients after the rehabilitation phase. METHODS Patients of 18 years or older with an injury severity score above 15 were included 15-53 months after their accident. Accident and patient characteristics were obtained from questionnaires and the trauma registry. Several questionnaires (Hospital Anxiety and Depression Scale, Impact of Events Scale, and Cognitive Failure Questionnaire) were used to determine the symptoms of psychological problems (anxiety or depression, post-traumatic stress disorder, or subjective cognitive complaints, respectively). The World Health Organization Quality of Life-Bref was used to determine QOL. A reference group of the Dutch general population was used for comparison of QOL scores. RESULTS The participation rate was 62 % (n = 173). At the time of the study, 30.1 % (n = 52) of the investigated patients had psychological complaints. No relation between psychological complaints and somatic severity or type of injury was found. Patients who were employed before the accident or resumed working reported less psychological complaints. Use of any medication before the accident and treatment for pre-accidental psychological problems were positively related to psychological complaints afterwards. QOL of severely injured patients was impaired in comparison with the general Dutch population, but only for those with psychological complaints. CONCLUSIONS Psychological complaints seem to be an important and underestimated factor for a decreased QOL among severely injured patients.
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Lam K, Chan SWC, Lam SC. Level of psychological distress and social support among patients with limb fractures in Hong Kong. J Clin Nurs 2010; 20:784-93. [DOI: 10.1111/j.1365-2702.2010.03326.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Andrew NE, Gabbe BJ, Wolfe R, Cameron PA. Evaluation of Instruments for Measuring the Burden of Sport and Active Recreation Injury. Sports Med 2010; 40:141-61. [DOI: 10.2165/11319750-000000000-00000] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Proinflammatory markers in prediction of posttraumatic psychological symptoms: a prospective cohort study. Mediators Inflamm 2008; 2008:640659. [PMID: 19125188 PMCID: PMC2607050 DOI: 10.1155/2008/640659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Revised: 10/09/2008] [Accepted: 11/10/2008] [Indexed: 11/18/2022] Open
Abstract
Introduction. Posttraumatic psychopathology (PTP) describes the spectrum of conditions that can complicate the recovery from commonly occurring musculoskeletal trauma. There is a clear association with the activation of the hypothalamic-pituitary-adrenal axis (HPAA), and we wished to examine the predictive value of proinflammatory markers of the HPAA and of the GABA, which acts as an inhibitory regulator. Methods. Levels of proinflammatory markers and GABA were measured in 84 patients who had suffered musculoskeletal injuries requiring hospitalisation. PTP was assessed by the use of the General Health Questionnaire (GHQ) at presentation and again at two- and six-month reviews. Results. Significant psychological disturbance was noted in 39% of patients at two months and falling back to 18% by six months. There was no correlation between any of the markers tested at presentation and PTP at follow-up. Discussion. The HPAA response to trauma and the development of PTP are extremely complex. It is unlikely that a simple blood assay will provide significant predictive information, while incident specific information and patient perception are of more practical use.
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