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Brooks SK, Rogers MB, Wessely S, Patel SS, Greenberg N. Psychosocial impacts of post-disaster compensation processes: narrative systematic review. BMC Psychol 2024; 12:539. [PMID: 39375791 DOI: 10.1186/s40359-024-02025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 09/20/2024] [Indexed: 10/09/2024] Open
Abstract
After disasters, many people seek compensation for physical, psychological or economic damages. However, compensation processes can be perceived as arduous and unfair and potentially create stress for both individuals and communities. This systematic review explored the psychosocial impacts of post-disaster compensation processes, including compensation sought through both litigation and government assistance programmes. We searched seven databases, hand-searched reference lists of included studies, and used thematic analysis to synthesise results of included studies. We screened 6,532 papers, ultimately including 66 in the review. While we found mixed evidence regarding the relationship between individual mental health and the compensation process, many studies suggested the process placed demands on emotional resources and could cause stress. Numerous challenges of the compensation process were described, including complicated paperwork, lengthy processes, inadequate information, confusing eligibility criteria, lack of inter-agency cooperation, poor understanding of communities' unique needs, insufficient pay-outs, and politicisation of the process. Inequities in compensation distribution introduced additional stress to already traumatised communities, who often experienced resentment, envy and conflict. The mixed nature of the relationship between mental health and the compensation process was evident in research trends where a small number of studies reported positive findings related to relating to gratitude, helpfulness of compensation and strengthened community relationships, while a substantial number of others reported negative impacts including higher mental health problems. Positive and negative impacts were reported for both litigation and non-litigation compensation-seeking. The nuanced dynamics of these findings are described in greater detail within the paper. It is important that compensation regulators consider the potential impacts on individuals and communities and take steps to address compensation inequities. This enhanced understanding of how those affected by disasters can rebuild their lives and furthering understanding of how to support them will enable evidence-based approaches to building resilience and planning for long-term recovery. Significant compensation process improvements could be realised by ensuring clear communication and transparent decision-making. Overall, this review underscores the importance of ensuring that compensation processes are fair and straightforward so they can repair material losses without deteriorating the social norms and relationships of affected communities.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, Weston Education Centre, King's College London, London, SE5 9RJ, UK.
| | - M Brooke Rogers
- Department of War Studies, King's College London, The Strand, London, WC2R 2LS, UK
| | - Simon Wessely
- Department of Psychological Medicine, Weston Education Centre, King's College London, London, SE5 9RJ, UK
| | - Sonny S Patel
- Transcultural Conflict and Violence Initiative, Georgia State University, Atlanta, GA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Neil Greenberg
- Department of Psychological Medicine, Weston Education Centre, King's College London, London, SE5 9RJ, UK
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Bernardo C, Hoon E, Gonzalez-Chica DA, Frank O, Black-Tiong S, Stocks N. Management of physical and psychological trauma resulting from motor vehicle crashes in Australian general practice: a mixed-methods approach. BMC PRIMARY CARE 2024; 25:167. [PMID: 38755534 PMCID: PMC11100075 DOI: 10.1186/s12875-024-02421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND In Australia, motor vehicle crashes (MVC)-related health data are available from insurance claims and hospitals but not from primary care settings. This study aimed to identify the frequency of MVC-related consultations in Australian general practices, explore the pharmacological management of health conditions related to those crashes, and investigate general practitioners' (GPs) perceived barriers and enablers in managing these patients. METHODS Mixed-methods study. The quantitative component explored annual MVC-related consultation rates over seven years, the frequency of chronic pain, depression, anxiety or sleep issues after MVC, and management with opioids, antidepressants, anxiolytics or sedatives in a sample of 1,438,864 patients aged 16 + years attending 402 Australian general practices (MedicineInsight). Subsequently, we used content analysis of 81 GPs' qualitative responses to an online survey that included some of our quantitative findings to explore their experiences and attitudes to managing patients after MVC. RESULTS MVC-related consultation rates remained stable between 2012 and 2018 at around 9.0 per 10,000 consultations. In 2017/2018 compared to their peers, those experiencing a MVC had a higher frequency of chronic pain (48% vs. 26%), depression/anxiety (20% vs. 13%) and sleep issues (7% vs. 4%). In general, medications were prescribed more after MVC. Opioid prescribing was much higher among patients after MVC than their peers, whether they consulted for chronic pain (23.8% 95%CI 21.6;26.0 vs. 15.2%, 95%CI 14.5;15.8 in 2017/2018, respectively) or not (15.8%, 95%CI 13.9;17.6 vs. 6.7%, 95% CI 6.4;7.0 in 2017/2018). Qualitative analyses identified a lack of guidelines, local referral pathways and decision frameworks as critical barriers for GPs to manage patients after MVC. GPs also expressed interest in having better access to management tools for specific MVC-related consequences (e.g., whiplash/seatbelt injuries, acute/chronic pain management, mental health issues). CONCLUSION Chronic pain, mental health issues and the prescription of opioids were more frequent among patients experiencing MVC. This reinforces the relevance of appropriate management to limit the physical and psychological impact of MVC. GPs identified a lack of available resources (e.g. education, checklists and management support tools) for managing MVC-related consequences, and the need for local referral pathways and specific guidelines to escalate treatments.
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Affiliation(s)
- Carla Bernardo
- Adelaide Medical School, The University of Adelaide, 115 Grenfell St, Level 8, Room 817.01, Adelaide, SA, 5000, Australia.
| | - Elizabeth Hoon
- Adelaide Medical School, School of Public Health, The University of Adelaide, 115 Grenfell St, Level 8, Room 818.01, Adelaide, SA, 5000, Australia
| | - David Alejandro Gonzalez-Chica
- Adelaide Medical School, Adelaide Rural Clinical School, The University of Adelaide, 115 Grenfell St, Level 8, Room 811C.02, Adelaide, SA, 5000, Australia
| | - Oliver Frank
- Adelaide Medical School, The University of Adelaide, 115 Grenfell St, Level 8, Room 817.09, Adelaide, SA, 5000, Australia
| | - Sean Black-Tiong
- Adelaide Medical School, The University of Adelaide, 115 Grenfell St, Level 8, Room 817, Adelaide, SA, 5000, Australia
| | - Nigel Stocks
- Adelaide Medical School, The University of Adelaide, 115 Grenfell St, Level 8, Room 823.01, Adelaide, SA, 5000, Australia
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Fraboni F, Morandini S, Zappalà S, Guglielmi D, Mariani MG, De Angelis M, Pietrantoni L. Occupational safety in homecare organizations: the design and implementation of a train-the-trainer program. Home Health Care Serv Q 2024; 43:87-113. [PMID: 38104310 DOI: 10.1080/01621424.2023.2292193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Homecare workers face significant occupational risks, necessitating effective safety training programs. This paper presents a comprehensive Train-the-Trainer (TTT) program developed to enhance occupational safety in homecare organizations. Through an analysis of 229 reported safety events, the frequency and type of incidents, such as injuries during handling, road crashes, slips, trips, and falls, were identified and primarily attributed to human errors and violations. Based on the results, a TTT program was designed and implemented. The TTT successfully engaged Health, Safety, and Environment managers, fostering collaborative activities, knowledge sharing, and resource discussions. The program modules address critical areas, including distractions and inattentions, fatigue, time pressure, frustration and aggressiveness, and safety behaviors. This innovative approach provides valuable insights for organizations seeking to improve homecare workers' safety. The findings add to the broader comprehension of occupational safety in the homecare sector, proposing a pragmatic framework for future interventions.
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Affiliation(s)
| | - Sofia Morandini
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | - Dina Guglielmi
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Education Studies, University of Bologna, Bologna, Italy
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Gopinath B, Jagnoor J, Kifley A, Pozzato I, Craig A, Cameron ID. Health literacy and recovery following a non-catastrophic road traffic injury. BMC Public Health 2022; 22:1380. [PMID: 35854243 PMCID: PMC9295516 DOI: 10.1186/s12889-022-13707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background Health literacy (HL) is rarely addressed in rehabilitation research and practice but can play a substantial role in the recovery process after an injury. We aimed to identify factors associated with low HL and its relationship with 6-month health outcomes in individuals recovering from a non-catastrophic road traffic injury. Methods Four hundred ninety-three participants aged ≥17 years who had sustained a non-catastrophic injury in a land-transport crash, underwent a telephone-administered questionnaire. Information was obtained on socio-economic, pre-injury health and crash-related characteristics, and health outcomes (quality of life, pain related measures and psychological indices). Low HL was defined as scoring < 4 on either of the two scales of the Health Literacy Questionnaire that covered: ability to actively engage with healthcare providers (‘Engagement’ scale); and/or understanding health information well enough to know what to do (‘Understanding’ scale). Results Of the 493, 16.9 and 18.7% scored < 4 on the ‘Understanding’ and ‘Engagement’ scale (i.e. had low HL), respectively. Factors that were associated with low HL as assessed by both scales were: having pre-injury disability and psychological conditions; lodging a third-party insurance claim; experiencing overwhelming/great perceived sense of danger/death during the crash; type of road user; low levels of social satisfaction; higher pain severity; pain catastrophizing; and psychological- and trauma-related distress. Low HL (assessed by both scales) was associated with poorer recovery outcomes over 6 months. In these longitudinal analyses, the strongest association was with disability (p < 0.0001), and other significant associations were higher levels of catastrophizing (p = 0.01), pain severity (p = 0.04), psychological- (p ≤ 0.02) and trauma-related distress (p = 0.003), lower quality of life (p ≤ 0.03) and physical functioning (p ≤ 0.01). Conclusions A wide spectrum of factors including claim status, pre-injury and psychological measures were associated with low HL in injured individuals. Our findings suggest that targeting low HL could help improve recovery outcomes after non-catastrophic injury.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia. .,Macquarie University Hearing, Department of Linguistics, Faculty of Medicine, Health and Human Sciences, The Australian Hearing Hub, 16 University Avenue, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Annette Kifley
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ilaria Pozzato
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
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Noël C, Scharf D, Hawkins J, Lund J, Kozik J, Péfoyo Koné A. Experiences, impacts and service needs of injured and ill workers in the WSIB process: evidence from Thunder Bay and District (Ontario, Canada). Health Promot Chronic Dis Prev Can 2022; 42:272-287. [PMID: 35830217 PMCID: PMC9436453 DOI: 10.24095/hpcdp.42.7.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Individuals experience negative physical, social and psychological ramifications when they are hurt or become ill at work. Ontario's Workplace Safety and Insurance Board (WSIB) is intended to mitigate these effects, yet the WSIB process can be difficult. Supports for injured workers can be fragmented and scarce, especially in underserved areas. We describe the experiences and mental health needs of injured and ill Northwestern Ontario workers in the WSIB process, in order to promote system improvements. METHODS Community-recruited injured and ill workers (n = 40) from Thunder Bay and District completed an online survey about their mental health, social service and legal system needs while involved with WSIB. Additional Northwestern Ontario injured and ill workers (n = 16) and community service providers experienced with WSIB processes (n = 8) completed interviews addressing similar themes. RESULTS Northwestern Ontario workers described the impacts of workplace injury and illness on their professional, family, financial and social functioning, and on their physical and mental health. Many also reported incremental negative impacts of the WSIB processes themselves, including regional issues such as "small town" privacy concerns and the cost burden of travel required by the WSIB, especially during COVID-19. Workers and service providers suggested streamlining and explicating WSIB processes, increasing WSIB continuity of care, and region-specific actions such as improving access to regional support services through arm's-length navigators. CONCLUSION Northwestern Ontario workers experienced negative effects from workplace injuries and illness and the WSIB process itself. Stakeholders can use these findings to improve processes and outcomes for injured and ill workers, with special considerations for the North.
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Affiliation(s)
- Chelsea Noël
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Deborah Scharf
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Joshua Hawkins
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Jewel Kozik
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada
| | - Anna Péfoyo Koné
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
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Shah P, Attia M, Dillon WA, Sulway S, Ranalli P, Rutka JA, Gerretsen P. Receiving Long-Term Disability or Pursuing a Legal Claim May Prevent Recovery From Chronic Dizziness. Laryngoscope 2021; 132:655-661. [PMID: 34591978 DOI: 10.1002/lary.29871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Chronic dizziness (CD) and imbalance have multiple etiologies. CD is strongly linked with psychiatric and psychological comorbidities, thus an interdisciplinary approach, including psychopharmacological interventions, is recommended. Despite the use of this comprehensive treatment approach, the recovery of individuals with CD that pursue long-term disability (LTD) insurance or legal claims (LC) appears hampered. As such, we aimed to compare symptom recovery from CD in an interdisciplinary setting between patients receiving LTD/LC versus those who were not, and to explore the factors that may contribute to changes in symptom severity. STUDY DESIGN Retrospective cohort study. METHODS Dizziness-related diagnoses were extracted from the charts of 195 adults in an outpatient interdisciplinary neurotology clinic in Toronto, Canada. Patients with baseline Dizziness Handicap Inventory (DHI) and Dizziness Catastrophizing Scale (DCS) assessments between August 2012 and July 2018 and a mean follow-up visit within approximately 10 months were included. The study participants were categorized as "LTD/LC+" (n = 92) or "LTD/LC-" (n = 103), referring to either receiving or pursuing LTD/LC or not, respectively. RESULTS There were differences in the mean percentage changes in DHI (t[187] = 3.02, P = .003) and DCS (t[179] = 2.63, P = .009) scores between LTD/LC+ and LTD/LC- patients. LTD/LC+ patients showed 8.0% and 7.6% mean increases in DHI and DCS scores, respectively, whereas LTD/LC- patients showed 21.5% and 25.9% reductions in DHI and DCS scores, respectively, controlling for age, sex, and baseline illness severity. CONCLUSIONS Patients receiving or pursuing LTD insurance or a legal claim did not improve from CD and dizziness catastrophizing compared to those who were not. Future studies are required to test these findings prospectively and to determine the factors that may contribute to symptom recovery, including the anxiety-aggravating effects of the LTD/LC process and the deleterious consequences of developing a sick-role while afflicted with a chronic illness. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Parita Shah
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Mohamed Attia
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Wanda A Dillon
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Shaleen Sulway
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Paul Ranalli
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John A Rutka
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
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Pozzato I, Tran Y, Gopinath B, Cameron ID, Craig A. The contribution of pre-injury vulnerability to risk of psychiatric morbidity in adults injured in a road traffic crash: Comparisons with non-injury controls. J Psychiatr Res 2021; 140:77-86. [PMID: 34098389 DOI: 10.1016/j.jpsychires.2021.05.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 11/26/2022]
Abstract
People who sustain injury in a road traffic crash (RTC) have significant risk of psychiatric morbidity, but effective screening for identifying at-risk individuals soon after the RTC is lacking. We investigated whether pre-injury vulnerability can assist as an early screen to manage this risk. We recruited 120 adults who sustained physical injury in a RTC and admitted to an emergency department (ED). They were comprehensively assessed for acute and long-term presence of psychiatric disorder/morbidity and disability over 12-months after the injury, with comparisons to a non-injury control. Propensity matching based on six pre-injury vulnerability factors (age, sex, education, socioeconomic status, prior mental health, prior physical health) with the control group was used to determine membership of high vulnerability (HV) and low vulnerability (LV) injury sub-groups. Compared to the LV sub-group and controls that had similar pre-injury vulnerability, the HV sub-group had a worrying post-RTC recovery profile, with significantly higher rates of long-term psychiatric morbidity (42.2% vs. 23.1% and 15.9% respectively, p = .002) including post-traumatic stress disorder and/or depression, and poorer psychological adjustment over the 12-months. In contrast, the HV and LV sub-groups were similar in injury-related characteristics and post-injury physical (pain, fatigue, physical functioning) and participation outcomes. Findings provide preliminary evidence that pre-injury vulnerability, primarily prior mental health status, is a promising screen for early identification of people at risk of psychiatric morbidity post-RTC. It is suggested this screen could be implemented in ED to prevent chronicity and improve recovery following a traumatic injury. Further research is warranted to enhance the screen's effectiveness.
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Affiliation(s)
- Ilaria Pozzato
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Yvonne Tran
- Centre of Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia
| | - Bamini Gopinath
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Ian Douglas Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Australia
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Rejection of workers' compensation claims may increase depressive symptoms among firefighters with occupational injury: a nationwide study in South Korea. Int Arch Occup Environ Health 2021; 94:1405-1413. [PMID: 33813675 DOI: 10.1007/s00420-021-01688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study sought to examine whether the experience of occupational injuries was associated with depressive symptoms and whether the rejection of workers' compensation claims was associated with depressive symptoms among Korean firefighters. METHODS We conducted a nationwide survey of 6793 Korean firefighters in 2015. Based on the experience of occupational injuries and workers' compensation claims over the past year, respondents were classified into four groups: "Not injured", "Injured, not applied", "Injured, applied, but rejected" and "Injured, applied, and accepted." Depressive symptoms over the preceding week were assessed using the 11-item version of the Centers for Epidemiologic Studies Depression Scale. RESULTS Compared to firefighters who did not get injured, injured firefighters had a higher prevalence of depressive symptoms (PR 2.01, 95% CI 1.83, 2.22) after controlling for confounders including job assignment. Also, when we restricted the analysis to injured firefighters, a higher prevalence of depressive symptoms was observed among "Injured, applied, but rejected" (PR 1.70, 95% CI 1.11, 2.59) group, compared to "Injured, applied, and accepted" group. CONCLUSIONS This finding suggests that rejection of workers' compensation claims, as well as the experience of occupational injuries, may increase the risk of depressive symptoms among Korean firefighters.
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Hung KKC, Kifley A, Brown K, Jagnoor J, Craig A, Gabbe B, Derrett S, Dinh M, Gopinath B, Cameron ID. Impacts of injury severity on long-term outcomes following motor vehicle crashes. BMC Public Health 2021; 21:602. [PMID: 33773593 PMCID: PMC8005247 DOI: 10.1186/s12889-021-10638-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia. Methods This inception cohort study followed 2019 people injured in MVCs, for 6 and 12 months post-injury. We categorised moderate injury as hospital length-of-stay (LOS) of 2–6 days and Injury Severity Score (ISS) of 4–11, while severe injury as LOS ≥7 days or ISS ≥ 12. We examined differences in paid work status, 12-Item Short Form Survey (SF12), EQ-5D and World Health Organisation Disability Assessment Schedule II (WHODAS) outcomes longitudinally from baseline to 12 months between levels of injury severity using linear mixed models for repeated measures. We first considered minimally sufficient adjustment factors (age, sex, crash role, perceived danger in crash, pre-injury health, pre-injury EQ-5D, recruitment source), and then more extensive adjustments including post-injury factors. The presence of mediating pathways for SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) via post-injury factors was evaluated. Results Based on hospital length of stay (LOS), 25 and 10% of participants sustained moderate and severe injuries, respectively, while 43 and 4% had these injuries based on ISS. Twelve months post-injury LOS ≥7 days versus ≤1 day was associated with an estimated 9 units lower mean SF12 PCS using a minimally sufficient adjustment model, and LOS ≥ 7 days was associated with a 3 units lower mean SF12 MCS score. Mediation analyses (LOS ≥ 7 days vs ≤1 day) found for SF12 MCS outcomes, effects of injury severity were small and mostly indirect (direct effect − 0.03, indirect effect − 0.22). Whereas for SF12 PCS outcomes the effect of having a more severe injury rather than mild were both direct and indirect (direct effect − 0.50, indirect effect − 0.38). Conclusions Individuals with severe injuries (those with LOS ≥ 7 days and ISS 12+) had poorer recovery 12 months after the injury. In addition, post-injury mediators have an important role in influencing long-term health outcomes. Trial registration Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10638-7.
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Affiliation(s)
- Kevin K C Hung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annette Kifley
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Level 13, Kolling building, St Leonards, Sydney, NSW, Australia
| | | | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Level 13, Kolling building, St Leonards, Sydney, NSW, Australia.,The George Institute for Global Health, Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Level 13, Kolling building, St Leonards, Sydney, NSW, Australia
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sarah Derrett
- Injury Prevention Research Unit (IPRU), Preventive & Social Medicine, Dunedin, New Zealand
| | - Michael Dinh
- Royal Prince Alfred Hospital, The University of Sydney, Sydney, Australia
| | - Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Level 13, Kolling building, St Leonards, Sydney, NSW, Australia.,Macquarie University Hearing, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Level 13, Kolling building, St Leonards, Sydney, NSW, Australia.
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Different Patterns of Mental Health Outcomes among Road Traffic Crash Survivors: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041564. [PMID: 33562205 PMCID: PMC7914793 DOI: 10.3390/ijerph18041564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate factors associated with the symptoms of mental disorders following a road traffic crash (RTC). A prospective cohort of 200 people was followed for 6 months after experiencing an RTC. The cohort was comprised of uninjured survivors and injured victims with all levels of road traffic injury (RTI) severity. Multivariable logistic regression analyses were performed to evaluate the associations between the symptoms of depression, posttraumatic stress disorder and anxiety one and six months after the RTC, along with sociodemographic factors, health status before and after the RTC, factors related to the RTI and factors related to the RTC. The results showed associations of depression, anxiety, and posttraumatic stress disorder symptoms with sociodemographic factors, factors related to the health status before and after the RTC and factors related to the RTC. Factors related to the RTI showed associations only with depression and posttraumatic stress disorder symptoms. Identifying factors associated with mental disorders following an RTC is essential for establishing screening of vulnerable individuals at risk of poor mental health outcomes after an RTC. All RTC survivors, regardless of their RTI status, should be screened for factors associated with mental disorders in order to successfully prevent them.
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Smits EJ, Gane EM, Brakenridge CL, Andrews NE, Johnston V. Expert consensus and perspectives on recovery following road traffic crashes: a Delphi study. Disabil Rehabil 2020; 44:3122-3131. [PMID: 33305970 DOI: 10.1080/09638288.2020.1855677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To reach expert consensus on a definition for recovery following minor and moderate road traffic crash-related injuries and key factors that influence recovery, and to explore expert perspectives on risk identification methods. MATERIALS AND METHODS A three-round Delphi study was conducted in which 47 experts (insurance representatives, health care professionals and researchers) were consulted. RESULTS Strong expert agreement (86%) was reached for the definition: "Recovery is multifaceted and includes return to activities of daily living (ADLs), work and social/leisure activities at pre-injury level or at a level deemed acceptable by the individual, with minimal ongoing pain and symptoms, considering physical and mental health and wellbeing". Agreed key factors that influenced recovery included: resilience; coping skills; recovery expectations; pre-existing physical and mental health; workplace support; and, collaboration between the injured individual, treating providers and claim handlers. Expert perspectives on risk identification methods were mixed. CONCLUSIONS An accepted definition for recovery following minor and moderate road traffic crash-related injury was established, which could facilitate communication and engagement between different rehabilitation stakeholders. Strong consensus was achieved on nine key factors that influenced recovery. Further research is needed to evaluate whether injured persons agree with this definition and on the utility of risk identification methods.Implications for rehabilitationExpert consensus was established for a definition of recovery following minor and moderate road traffic crash-related injuries and nine key influencing factors.An established definition could facilitate communication and engagement between all rehabilitation stakeholders, which could improve the recovery process of the injured person.Rehabilitation professionals need to be familiar with the role of psychosocial factors, such as recovery expectations, resilience and coping skills, in the recovery process.The use of physical and psychological outcome measures at regular intervals could help to identify risk of poor recovery following minor and moderate road traffic crash-related injuries.
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Affiliation(s)
- Esther J Smits
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Elise M Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia.,Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | | | - Nicole E Andrews
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.,Occupational Therapy Department, The Professor Tess Cramond Multidisciplinary Pain Centre, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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12
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Nguyen TL, Baker KS, Ioannou L, Hassani-Mahmooei B, Gibson SJ, Collie A, Ponsford J, Cameron PA, Gabbe BJ, Giummarra MJ. Prognostic Role of Demographic, Injury and Claim Factors in Disabling Pain and Mental Health Conditions 12 Months after Compensable Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7320. [PMID: 33036417 PMCID: PMC7579145 DOI: 10.3390/ijerph17197320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3-6 months post-injury, persistent work disability and opioid use at 6-12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3-6 months, work disability and psychotropic medications at 6-12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed.
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Affiliation(s)
- Thi L. Nguyen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Katharine S. Baker
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, 27 Rainforest Walk, Clayton, VIC 3800, Australia; (K.S.B.); (J.P.)
| | - Liane Ioannou
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Behrooz Hassani-Mahmooei
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Stephen J. Gibson
- Caulfield Pain Management and Research Centre, Caulfield Hospital, 260–294 Kooyong Rd, Caulfield, VIC 3162, Australia;
| | - Alex Collie
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, 27 Rainforest Walk, Clayton, VIC 3800, Australia; (K.S.B.); (J.P.)
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, 89 Bridge Rd, Richmond, VIC 3121, Australia
| | - Peter A. Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Belinda J. Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
- Health Data Research UK, Swansea University Medical School, Swansea University, Wales, Sketty, Swansea SA2 8QA, UK
| | - Melita J. Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
- Caulfield Pain Management and Research Centre, Caulfield Hospital, 260–294 Kooyong Rd, Caulfield, VIC 3162, Australia;
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13
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Brown K, Cameron ID, Keay L, Rogers K, Nguyen H, Vines P, Ivers R. Factors influencing duration of compensation following road traffic crash injury in older vs younger adults. Australas J Ageing 2020; 40:e13-e21. [PMID: 33025702 DOI: 10.1111/ajag.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/10/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors independently associated with late claim closure, a proxy for recovery, in older (65+ years) compared to younger (17-64 years) adults following road traffic crash injury (RTI). METHODS Multivariable analysis of statewide compensation data from New South Wales (NSW), Australia, for NSW residents aged ≥17 years injured in a non-catastrophic RTI between July 2010 and June 2013 with finalised claims (n = 16 687). RESULTS Legal representation was the dominant factor independently associated with late claim closure in both age groups. However, the odds were doubly high for the younger group (younger: AOR 8.46, 95% CI 7.7-9.4; older: AOR 3.95, 95% CI 3.1-5.0). Median time to claim closure was shorter for older people. CONCLUSION Older (and younger) claimants with legal representation are at increased risk of late claim closure and can be readily identified within routinely collected compensation data, enabling delivery of targeted strategies or supports early in the claims process.
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Affiliation(s)
- Katherine Brown
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia
| | - Ian D Cameron
- Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Kolling Institute, Royal North Shore Hospital, the University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ha Nguyen
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Kolling Institute, Royal North Shore Hospital, the University of Sydney, Sydney, New South Wales, Australia
| | - Prue Vines
- Faculty of Law, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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14
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Giummarra MJ, Murgatroyd D, Tran Y, Adie S, Mittal R, Ponsford J, Cameron P, Gabbe B, Harris IA, Cameron ID. Health and return to work in the first two years following road traffic injury: a comparison of outcomes between compensation claimants in Victoria and New South Wales, Australia. Injury 2020; 51:2199-2208. [PMID: 32680598 DOI: 10.1016/j.injury.2020.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/16/2020] [Accepted: 07/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND People who sustain road traffic injuries often have poor health outcomes. While outcomes are often worse in people with a compensation claim, especially in fault-based schemes versus no-fault schemes, few studies have directly compared outcomes across scheme types. OBJECTIVE To compare health and work outcomes between people who had no compensation claim, a fault-based claim, or "no-fault" transport or workers compensation claim after hospitalisation for a road traffic injury. METHODS Participants aged >=18 years admitted to hospital in New South Wales or Victoria for >24 hours were recruited in two separate prospective cohort studies (N=1,034). People who died or sustained minor or very severe injuries were excluded. Groups included Compulsory Third Party (fault-based, n=128), no-fault Transport Accident Commission (TAC; n=454) and workers compensation claimants (n=73), or no claim (n=226). Outcomes at six, 12- and 24-months post-injury included health [SF-12 Mental Component Score (MCS) and Physical Component Score (PCS)], and return to work for people working pre-injury. Multivariable mixed effects linear and logistic regressions, adjusting for demographic and injury covariates, examined differences in health and work outcomes between claimant groups, with fixed effects of time and random effects of participant ID. RESULTS Health status was better in people with a no-fault TAC claim (MCS: m=50.62, 95%CI:49.62,51.62; PCS: m=40.49, 95%CI:39.46,41.52) or no claim (MCS: m=49.99, 95%CI:49.62,51.62; PCS: m=44.36, 95%CI:43.00,45.72), than people with a workers compensation (MCS: m=45.73, 95%CI:43.46,48.00; PCS: m=38.94, 95%CI:36.59,41.30) or fault-based CTP claim (MCS: m=41.34, 95%CI:39.54,43.13; PCS: m=35.64, 95%CI:33.78,37.49). Relative to fault-based CTP claimants, the odds of returning to work were higher for people with no claim (AOR=6.84, 95%CI:1.73,27.05) but did not differ for no-fault TAC (AOR=1.21, 95%CI:0.36,4.05) or workers compensation claimants (AOR=0.83,95%CI: 0.17,3.99). While people with a fault-based CTP claim had poorer mental and physical health and return to work after injury, they showed greater improvements in mental health, and similar levels of improvement in physical health and work participation over time to the other groups. CONCLUSION The patterns of health and work across scheme types provide important insights against which we can contrast the effects of future scheme designs on client outcomes.
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.
| | - Darnel Murgatroyd
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney.
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University.
| | - Sam Adie
- South West Sydney Clinical School, University of New South Wales, Australia.
| | - Rajat Mittal
- South West Sydney Clinical School, University of New South Wales, Australia.
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Clayton Victoria, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia.
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Belinda Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Health Data Research UK, Swansea University Medical School, Singleton Park, Swansea University, Swansea, Wales, UK SA2 8PP.
| | - Ian A Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney.
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney.
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15
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Gopinath B, Jagnoor J, Kifley A, Dinh M, Craig A, Cameron ID. Predictors of health-related quality of life after non-catastrophic injury sustained in a road traffic crash. Ann Phys Rehabil Med 2020; 63:280-287. [DOI: 10.1016/j.rehab.2019.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/29/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
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16
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Giummarra MJ, Lau G, Grant G, Gabbe BJ. A systematic review of the association between fault or blame-related attributions and procedures after transport injury and health and work-related outcomes. ACCIDENT; ANALYSIS AND PREVENTION 2020; 135:105333. [PMID: 31863937 DOI: 10.1016/j.aap.2019.105333] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/07/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Attributions of fault are often associated with worse injury outcomes; however, the consistency and magnitude of these impacts is not known. This review examined the prognostic role of fault on health, mental health, pain and work outcomes after transport injury. A systematic search of five electronic databases (Medline, Embase, CINAHL, PsycINFO, Cochrane Library) yielded 16,324 records published between 2000 and January 2018. Eligibility criteria were: adult transport injury survivors; prospective design; multivariable analysis; fault-related factor analysed; pain, mental health, general health or work-related outcome. Citations (n = 10,558, excluding duplicates) and full text articles (n = 555) were screened manually (Reviewer 1), and using concurrent machine learning and text mining (Reviewer 2; using Abstrackr, WordStat and QDA miner). Data from 55 papers that met all inclusion criteria were extracted, papers were evaluated for risk of bias using the QUIPS tool, and overall level of evidence was assessed using the GRADE tool. There were six main fault-related factors classified as: fault or responsibility, fault-based compensation, lawyer involvement or litigation, blame or guilt, road user or position in vehicle, and impact direction. Overall there were inconsistent associations between fault and transport injury outcomes, and 60% of papers had high risk of bias. There was moderate evidence that fault-based compensation claims were associated with poorer health-related outcomes, and that lawyer involvement was associated with poorer work outcomes beyond 12 months post-injury. However, the evidence of negative associations between fault-based compensation claims and work-related outcomes was limited. Lawyer involvement and fault-based compensation claims were associated with adverse mental health outcomes six months post-injury, but not beyond 12 months. The most consistent associations between fault and negative outcomes were not for fault attributions, per se, but were related to fault-related procedures (e.g., lawyer engagement, fault-based compensation claims).
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
| | - Georgina Lau
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Genevieve Grant
- Australian Centre for Justice Innovation and Faculty of Law, Monash University, Clayton, VIC, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, Wales, UK
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17
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Kovacevic J, Miskulin M, Degmecic D, Vcev A, Leovic D, Sisljagic V, Simic I, Palenkic H, Vcev I, Miskulin I. Predictors of Mental Health Outcomes in Road Traffic Accident Survivors. J Clin Med 2020; 9:jcm9020309. [PMID: 31979086 PMCID: PMC7074414 DOI: 10.3390/jcm9020309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/18/2020] [Accepted: 01/19/2020] [Indexed: 11/16/2022] Open
Abstract
Mental health outcomes of road traffic accidents (RTAs) are always investigated in assessments of those involved. The aim of this study was to investigate the psychological consequences and associated factors in all RTA survivors, irrelevant of their injury status. A cohort of 155 people was assessed one month after experiencing a RTA using self-reported measures for posttraumatic stress disorder (PTSD), depression, and anxiety. Associations between mental health outcomes and sociodemographic factors, pre-RTA health status, injury-related factors, and RTA details were analyzed. RTA survivors reported substantial rates of PTSD (32.3%) and depression (17.4%) symptoms, and low rates of anxiety (5.8%). Symptoms of depression were associated with below-average self-perceived economic status, irreligiousness, medication use, psychiatric medication use, and injury-related factors. PTSD symptoms were associated with female gender, below-average self-perceived economic status, previous psychiatric illness, medication use, psychiatric medication use, not being at fault in the relevant RTA, claiming compensation, and injury-related factors. Anxiety symptoms were associated with previous chronic or psychiatric illness, previous permanent pain, psychiatric medication use, and self-perceived threat to life, but not with sustaining injury. Along with the evaluation and treatment of RTA injuries, health care providers should evaluate the pre-RTA health status of all RTA victims. Psychological support to those at risk may prevent psychological disorders after RTAs.
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Affiliation(s)
- Jelena Kovacevic
- Institute of emergency medicine of the Vukovar-Srijem County, 32 100 Vinkovci, Croatia;
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
| | - Maja Miskulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
| | - Dunja Degmecic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Department of Psychiatry, University Hospital Osijek, 31000 Osijek, Croatia
| | - Aleksandar Vcev
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Internal Medicine, University Hospital Osijek, 31000 Osijek, Croatia
| | - Dinko Leovic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
| | - Vladimir Sisljagic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Department of Surgery, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivana Simic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Institute of Public Health for the Osijek-Baranja County, 31 000 Osijek, Croatia
| | - Hrvoje Palenkic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Department of Surgery, General Hospital Slavonski Brod, 35 000 Slavonski Brod, Croatia
| | - Ivan Vcev
- Department of Humanities, University of Zadar, 23 000 Zadar, Croatia;
| | - Ivan Miskulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.M.); (D.D.); (A.V.); (D.L.); (V.S.); (I.S.); (H.P.)
- Correspondence: ; Tel.: +385-91-224-1500
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18
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Trippolini MA, Young AE, Pransky G, Elbers NA, Lockwood K, Cameron ID. Beyond symptom resolution: insurance case manager's perspective on predicting recovery after motor vehicle crash. Disabil Rehabil 2019; 43:498-506. [PMID: 31368814 DOI: 10.1080/09638288.2019.1630857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Insurance company case managers can play a critical role in the rehabilitation process of people with musculoskeletal disorders sustained following minor motor vehicle crash injury due to their interaction with multiple stakeholders and their role in approving various services. This study aimed to identify factors that case managers perceive as predictive of recovery in people with musculoskeletal disorders after minor motor vehicle crash injury. MATERIALS AND METHODS To explore the perspectives of cases managers in Australia and the United States, semi-structured interviews explored factors that case managers thought provided an early indication of likely recovery outcomes in people with musculoskeletal disorders after minor motor vehicle crash injury. A framework analysis was applied and factors were displayed within the ICF-framework. RESULTS Case managers (n = 40) demonstrated a broad, detailed understanding of biopsychosocial and contextual issues influencing recovery. They emphasized the importance of the injured worker's expressed affect and motivation, style of communication, the role of lawyers, the worker's family and friends, as well as cultural and geographic influences. The overarching themes perceived as having a major influence on recovery outcomes were general health, pain processing and response, work situation, and compensation entitlement. CONCLUSIONS Case managers' broad and detailed perceptions about recovery may provide additional, valuable perspectives for professionals involved in the rehabilitation process of people with musculoskeletal disorders after minor motor vehicle crash injury. Further research needs to be conducted to explore the effects of case manager involvement in the process of recovery.Implications for rehabilitationInsurance Case Managers identified multiple factors including affect and motivation, style of communication, the role of lawyers, family and friends, cultural and geographic variation provide opportunities for more effective treatment of people with musculoskeletal disorders related to minor motor vehicle collisions. These managers' perceptions about recovery may be informative to and provide opportunities for health professionals involved in the rehabilitation of people with musculoskeletal disorders related to minor motor vehicle collisions.While the Insurance Case Managers involved in this research did not use formalized assessment techniques, tools and assessment protocols could be developed jointly between for the needs of Insurance Case Managers and other stakeholders to tackle recovery of people with musculoskeletal disorders related to minor motor vehicle collision.
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Affiliation(s)
- Maurizio A Trippolini
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA.,Massachusetts General Hospital (MGH) Institute for Health Professions, Boston, MA, USA.,Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Amanda E Young
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA.,Young Normandeau & Co, Hopkinton, MA, USA
| | - Glenn Pransky
- Department of Quantitative Health sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nieke A Elbers
- Faculty of Law, Netherlands Institute for the Study of Crime and Law enforcement, VU University Amsterdam, Amsterdam, The Netherlands
| | - Keri Lockwood
- John Walsh Centre for Rehabilitation Research, Kolling Institute, University of Sydney, St Leonards, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute, University of Sydney, St Leonards, Australia
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19
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Work absence following road traffic crash in Victoria, Australia: A population-based study. Injury 2019; 50:1293-1299. [PMID: 31176478 DOI: 10.1016/j.injury.2019.05.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Road traffic crash (RTC) burden is typically reported using hospitalisations or fatalities, yet alternative measures such as work absence provide further insight into RTC impacts. This study aimed to quantify work absence due to compensable RTCs in Victoria, and to determine the characteristics associated with prolonged work absence. METHODS In Victoria, Australia, two systems provide income support whilst unable to work, among other benefits, to those injured during RTCs either at work (workers' compensation: WC) or elsewhere (RTC compensation). Administrative data of accepted claims between July 1 2003 and June 30, 2013 were included from working age people (15-65 years) if at least one day of income support was paid. Total time (in weeks) on income support, and hence absent from work, was calculated for each person and for each predictor (age group, sex, compensation system, length of hospital stay, injury type and road user type). Cox regression was used to determine the likelihood of prolonged work absence by predictor, presented as hazard ratios (HR) with 95% confidence intervals. RESULTS For 36,640 injured people, 1,121,863 weeks were compensated (median 10 weeks). Median work absence was shortest among those involved in a train/tram crash (2.9 weeks, HR:0.57[0.51-0.64]) and those with contusions/abrasions (3.7 weeks, HR:0.66[0.64,0.69]). Median work absence was longest among those with spinal cord injury (115.9 weeks, HR:1.56[1.26,1.92]) or severe acquired brain injury (129.6 weeks, HR:1.60[1.44,1.77]). Work absence likelihood increased with length of hospital stay. Median work absence was similar between compensation systems (WC: 10.1 weeks, RTC: 10.0 weeks) yet likelihood of greater work absence was higher in the RTC compensation system (HR:1.12[1.08,1.17]). CONCLUSIONS Work absence is both a measureable and important metric for assessing the impact of RTC injury in those working at the time of injury. Work absence was at least ten weeks for more than half of all injured persons, reinforcing need for road safety, injury prevention, and return to work services. Furthermore, this study identified those most at risk of prolonged work absence, providing the opportunity to target specific individuals to develop strategies to reduce work absence, such as occupation-specific rehabilitation or graduated return to work.
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Guest R, Tran Y, Gopinath B, Cameron ID, Craig A. Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation. BMC Psychol 2018; 6:4. [PMID: 29467035 PMCID: PMC5822643 DOI: 10.1186/s40359-018-0216-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical injury and psychological disorder following a motor vehicle crash (MVC) is a public health concern. The objective of this research was to determine rates of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in adults with MVC-related injury engaged in compensation, and to determine the capacity (e.g. sensitivity and specificity) of two psychometric scales for estimating the presence of MDD and PTSD. METHODS Participants included 109 adults with MVC-related injury engaged in compensation during 2015 to 2017, in Sydney, Australia. The mean time from MVC to baseline assessment was 11 weeks. Comprehensive assessment was conducted at baseline, and the Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) were administered to determine probable MDD and PTSD. An online psychiatric interview, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5), was used to diagnose actual MDD and PTSD, acknowledged as gold standard diagnostic criteria. One-way multivariate analyses of variance established criterion validity of the DASS-21 and IES-R, and sensitivity and specificity analyses were conducted to determine the most sensitive cut-off points for detecting probable MDD and PTSD. RESULTS Substantial rates of MDD (53.2%) and PTSD (19.3%) were found. The DASS-21 and IES-R were shown to have excellent criterion validity for detecting MDD and PTSD in injured participants. A range of cut-off points were investigated and shown to have acceptable sensitivity and specificity for detecting MDD and PTSD in an injured population engaged in compensation. The preferred cut-off points based on this study are: to detect MDD, a DASS-21 total score of 30 and/or a DASS-21 depression score of 10; to detect PTSD, IES-R scores of 33-40 and/or a DASS-21 anxiety score of 7-8. CONCLUSIONS Major psychological disorder is prevalent following a MVC. Results suggest the DASS-21 and IES-R are suitable for use in clinical/compensation settings to detect probable MDD and PTSD soon after a MVC in physically injured people engaged in compensation. These results provide positive direction in the public health arena for improving mental health outcomes. TRIAL REGISTRATION Clinical Trials registration number: ANZCTR - ACTRN12615000326594 (9th April 2015).
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Affiliation(s)
- Rebecca Guest
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, NSW Australia
- Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, Royal North Shore Hospital, Corner Reserve Road & Westbourne Street, St Leonards, NSW 2065 Australia
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, NSW Australia
- Key University Centre for Health Technologies, University of Technology, Broadway, Sydney, NSW Australia
| | - Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, NSW Australia
| | - Ian D. Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, NSW Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, The University of Sydney, Kolling Institute of Medical Research, St Leonards, NSW Australia
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Rudbeck M, Johansen JP, Omland Ø. A follow-up study of coping strategies of compensation claimants reporting an occupational injury associated with return to work/disability benefits in the subsequent year. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1493911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Marianne Rudbeck
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Jens Peter Johansen
- Department of Occupational Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Øyvind Omland
- Department of Occupational Medicine, Aalborg University Hospital, Aalborg, Denmark
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Craig A, Elbers NA, Jagnoor J, Gopinath B, Kifley A, Dinh M, Pozzato I, Ivers RQ, Nicholas M, Cameron ID. The psychological impact of traffic injuries sustained in a road crash by bicyclists: A prospective study. TRAFFIC INJURY PREVENTION 2017; 18:273-280. [PMID: 27764546 DOI: 10.1080/15389588.2016.1248760] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/12/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the psychological impact of traffic injuries in bicyclists (cyclists) in comparison to car occupants who also sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated. METHODS An inception cohort prospective design was used. Participants included cyclists aged ≥17 years (mean age 41.7 years) who sustained a physical injury (n = 238) assessed within 28 days of the crash, following medical examination by a registered health care practitioner. Injury included musculoskeletal and soft tissue injuries and minor/moderate traumatic brain injury (TBI), excluding severe TBI, spinal cord injury, and severe multiple fractures. Assessment also occurred 6 months postinjury. Telephone-administered interviews assessed a suite of measures including sociodemographic, preinjury health and injury factors. Psychological impact was measured by pain catastrophization, trauma-related distress, and general psychological distress. The psychological health of the cyclists was compared to that of the car occupants (n = 234; mean age 43.1 years). A mixed model repeated measures analysis, adjusted for confounding factors, was used to determine differences between groups and regression analyses were used to determine contributors to psychological health in the cyclists 6 months postinjury. RESULTS Cyclists had significantly better psychological health (e.g., lower pain catastrophizing, lower rates of probable posttraumatic stress disorder [PTSD], and lower general distress levels) compared to car occupants at baseline and 6 months postinjury. Factors predictive of cyclists' psychological distress included younger age, greater perceived danger of death, poorer preinjury health, and greater amount of time in hospital after the injury. CONCLUSIONS These data provide insight into how cyclists perceive and adjust to their traffic injuries compared to drivers and passengers who sustain traffic injuries, as well as direction for preventing the development of severe psychological injury. Future research should examine the utility of predictors of psychological health to improve recovery.
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Affiliation(s)
- A Craig
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
| | - N A Elbers
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
| | - J Jagnoor
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
- b The George Institute for Global Health, Sydney Medical School, The University of Sydney , Sydney , New South Wales , Australia
| | - B Gopinath
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
| | - A Kifley
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
| | - M Dinh
- c Department of Trauma Services , Royal Prince Alfred Hospital , Sydney , New South Wales , Australia
| | - I Pozzato
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
| | - R Q Ivers
- b The George Institute for Global Health, Sydney Medical School, The University of Sydney , Sydney , New South Wales , Australia
| | - M Nicholas
- d Pain Management Research Institute, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
| | - I D Cameron
- a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia
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Gopinath B, Jagnoor J, Elbers N, Cameron ID. Overview of findings from a 2-year study of claimants who had sustained a mild or moderate injury in a road traffic crash: prospective study. BMC Res Notes 2017; 10:76. [PMID: 28143537 PMCID: PMC5286861 DOI: 10.1186/s13104-017-2401-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 01/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies have shown that in people injured in a road traffic crash, persistent symptoms are common and can lead to significant ongoing personal impact. Hence, elucidating factors associated with the human costs are key to reducing the socio-economic burden of road traffic injuries. Therefore, in this study we aimed to track the experience and key outcomes of persons who had sustained mild/moderate injuries as they returned to health (and work, where relevant) following a road traffic crash. RESULTS It is an inception study cohort of adults who had sustained mild to moderate injuries (that is, except serious injuries) in motor vehicle crashes in New South Wales, Australia, who were recruited and interviewed at baseline (within 3 months of the crash) and at 6, 12 and 24 months post-injury. We found that minor injuries had major impacts on pain ratings, physical and mental well-being, health-related quality of life and return to work and pre-injury participation during the 24 months post-injury phase. Further, for mild to moderately severe injuries, biopsychosocial factors appear to be prognostic indicators of recovery (not the location or type of injury). Examples of key biopsychosocial factors are: age; preinjury health; quality of life; reactions to injury (catastrophising, and pain); social support and the third party insurance compensation system. DISCUSSION This study highlights the considerable impact of apparently "minor" road traffic crash injuries at a population level and suggests targeted approaches to the tertiary prevention of long-term morbidity and disability. Study findings have also reiterated the importance of looking beyond the injury to the 'whole person'.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia. .,John Walsh Centre for Rehabilitation Research, Kolling Institute, Royal North Shore Hospital, Corner Reserve Road & First Avenue, St Leonards, NSW, 2065, Australia.
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.,The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Nieke Elbers
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
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Abstract
Synopsis Recovery from a whiplash injury is varied and complex. Some individuals recover quickly and fully, while others experience ongoing pain and disability. Three distinct patterns of predicted recovery (trajectories) have been identified using disability and psychological outcome measures. These trajectories are not linear, and show that recovery, if it is going to occur, tends to happen within the first 3 months of the injury, with little improvement after this period. Identification of factors associated with poor recovery is accumulating, and since 2000 there have been at least 10 published systematic reviews on prognostic factors for whiplash-associated disorder. Poor recovery has been consistently reported to be associated with high initial neck pain intensity and neck-related disability, posttraumatic stress symptoms, pain catastrophizing, and, to a lesser extent, low self-efficacy and cold hyperalgesia. Evidence regarding factors, including compensation status, psychological factors, structural pathology, and preinjury health status, remains equivocal. Given the huge number of predictive factors and various interpretations of recovery, adapting these data for use in clinical practice is difficult. Tools such as clinical prediction rules (CPRs), by statistically quantifying relevant data, may help to predict the probability of diagnosis, prognosis, or response to treatment. Numerous CPRs have been derived for individuals with whiplash; however, to date, only 3 prognostic CPRs have undergone external validation, and none have yet undergone impact analysis, a necessary step in providing information about the rules' ability to improve clinically relevant outcomes. J Orthop Sports Phys Ther 2016;46(10):851-861. Epub 3 Sep 2016. doi:10.2519/jospt.2016.6918.
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Craig A, Tran Y, Guest R, Gopinath B, Jagnoor J, Bryant RA, Collie A, Tate R, Kenardy J, Middleton JW, Cameron I. Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis. BMJ Open 2016; 6:e011993. [PMID: 27609849 PMCID: PMC5020848 DOI: 10.1136/bmjopen-2016-011993] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this meta-analysis was to determine the psychological impact associated with motor vehicle crash (MVC)-related physical injuries. DESIGN Systematic review and meta-analysis. DATA SOURCES Multiple search engines included MEDLINE (via OVID), PsycINFO and Embase, and studies were sourced from scientific journals, conference papers and doctoral theses. STUDY SELECTION A high-yield search strategy was employed. Terms like 'psychological distress', 'depression', 'PTSD' and 'motor vehicle accident' were employed. These key words were run primarily and secondary searches were then conducted in association with the major injury types. Studies needed to compare psychological distress in people injured in an MVC with uninjured controls who had not recently experienced an MVC. DATA EXTRACTION Searches resulted in the identification of 2537 articles, and after eliminating duplicates and studies not meeting inclusion criteria, 24 studies were selected involving 4502 injured participants. These studies were entered into separate meta-analyses for mild to moderate traumatic brain injury (mTBI), whiplash-associated disorder (WAD) and spinal cord injury (SCI). RESULTS Elevated psychological distress was associated with MVC-related injuries with a large summary effect size in WAD (0.90), medium to large effect size in SCI (0.69) and small to medium effect size in mTBI (0.23). No studies meeting inclusion criteria were found for burns, fractures and low back injury. Increased psychological distress remains elevated in SCI, mTBI and WAD for at least 3 years post-MVC. CONCLUSIONS Rehabilitation strategies are needed to minimise distress subsequent to MVC-related physical injuries and the scientific robustness of studies requires improvement.
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Affiliation(s)
- Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Rebecca Guest
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Kensington, New South Wales, Australia
| | - Alex Collie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Justin Kenardy
- School of Psychology and Centre of National Research on Disability and Rehabilitation Medicine (CONROD), University of Queensland, Brisbane, Queensland, Australia
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Ian Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
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Elbers NA, Collie A, Hogg-Johnson S, Lippel K, Lockwood K, Cameron ID. Differences in perceived fairness and health outcomes in two injury compensation systems: a comparative study. BMC Public Health 2016; 16:658. [PMID: 27473747 PMCID: PMC4966779 DOI: 10.1186/s12889-016-3331-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/21/2016] [Indexed: 12/04/2022] Open
Abstract
Background Involvement in a compensation process following a motor vehicle collision is consistently associated with worse health status but the reasons underlying this are unclear. Some compensation systems are hypothesised to be more stressful than others. In particular, fault-based compensation systems are considered to be more adversarial than no-fault systems and associated with poorer recovery. This study compares the perceived fairness and recovery of claimants in the fault-based compensation system in New South Wales (NSW) to the no-fault system in Victoria, Australia. Methods One hundred eighty two participants were recruited via claims databases of the compensation system regulators in Victoria and NSW. Participants were > 18 years old and involved in a transport injury compensation process. The crash occurred 12 months (n = 95) or 24 months ago (n = 87). Perceived fairness about the compensation process was measured by items derived from a validated organisational justice questionnaire. Health outcome was measured by the initial question of the Short Form Health Survey. Results In Victoria, 84 % of the participants considered the claims process fair, compared to 46 % of NSW participants (χ2 = 28.54; p < .001). Lawyer involvement and medical assessments were significantly associated with poorer perceived fairness. Overall perceived fairness was positively associated with health outcome after adjusting for demographic and injury variables (Adjusted Odds Ratio = 2.8, 95 % CI = 1.4 – 5.7, p = .004). Conclusion The study shows large differences in perceived fairness between two different compensation systems and an association between fairness and health. These findings are politically important because compensation processes are designed to improve recovery. Lower perceived fairness in NSW may have been caused by potential adversarial aspects of the scheme, such as liability assessment, medical assessments, dealing with a third party for-profit insurance agency, or financial insecurity due to lump sum payments at settlement. This study should encourage an evidence informed discussion about how to reduce anti-therapeutic aspects in the compensation process in order to improve the injured person’s health.
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Affiliation(s)
- Nieke A Elbers
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Sydney, Australia.
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia
| | | | | | - Keri Lockwood
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Sydney, Australia
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Gopinath B, Elbers NA, Jagnoor J, Harris IA, Nicholas M, Casey P, Blyth F, Maher CG, Cameron ID. Predictors of time to claim closure following a non-catastrophic injury sustained in a motor vehicle crash: a prospective cohort study. BMC Public Health 2016; 16:421. [PMID: 27207479 PMCID: PMC4875669 DOI: 10.1186/s12889-016-3093-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 05/11/2016] [Indexed: 12/02/2022] Open
Abstract
Background Research suggests that exposure to the compensation system (including time to case closure) could adversely influence a persons’ recovery following injury. However, the long-term predictors of time to claim closure following minor road traffic injuries remain unclear. We aimed to assess a wide spectrum of factors that could influence time to claim closure (socio-demographic, compensation-related, health, psychosocial and pre-injury factors) over 24 months following a non-catastrophic injury. Methods Prospective cohort study of 364 participants involved in a compensation scheme following a motor vehicle crash. We used a telephone-administered questionnaire to obtain information on potential explanatory variables. Information on time to claim closure was obtained from an insurance regulatory authority maintained database, and was classified as the duration between the crash date and claim settlement date, and categorized into < 12 (early), > 12–24 (medium) and > 24 months (late). Results Just over half of claimants (54 %) had settled their claim by 12 months, while 17 % and 30 % took > 12–24 months and > 24 months for claim closure, respectively. Whiplash at baseline was associated with claim closure time of > 12–24 months versus < 12 months: multivariable-adjusted OR 2.38 (95 % CI 1.06–5.39). Claimants who were overweight/obese versus normal/underweight at the time of injury were ~3.0-fold more likely to settle their claim at > 12–24 months than < 12 months. Consulting a lawyer was associated with a 10.4- and 21.0-fold increased likelihood of settling a claim at > 12–24 months and > 24 months, respectively. Each 1-unit increase in Orebro Musculoskeletal Pain Screening Questionnaire scores at baseline was associated with greater odds of both medium (> 12–24 months) and delayed claim settlement date (> 24 months): multivariable-adjusted OR 1.04 (95 % CU 1.01–1.07) and 1.02 (95 % CI 1.00–1.05), respectively. Conclusions Around a third of claimants with a minor injury had not settled by 24 months. Health-related factors and lawyer involvement independently influenced time to claim closure.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Studies, Kolling Institute of Medical Research, University of Sydney, Corner Reserve Road & First Avenue, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| | - Nieke A Elbers
- John Walsh Centre for Rehabilitation Studies, Kolling Institute of Medical Research, University of Sydney, Corner Reserve Road & First Avenue, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Studies, Kolling Institute of Medical Research, University of Sydney, Corner Reserve Road & First Avenue, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Ian A Harris
- Ingham Institute for Applied Medical Research, University of New South Wales, New South Wales, Australia
| | - Michael Nicholas
- Pain Management Research Institute, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Petrina Casey
- John Walsh Centre for Rehabilitation Studies, Kolling Institute of Medical Research, University of Sydney, Corner Reserve Road & First Avenue, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Fiona Blyth
- Pain Management Research Institute, Sydney Medical School, University of Sydney, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - Christopher G Maher
- George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Studies, Kolling Institute of Medical Research, University of Sydney, Corner Reserve Road & First Avenue, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
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Trost Z, Monden KR, Buelow M, Boals A, Scott W. Perceived Injustice Predicts Intention to Litigate: Findings from a Spinal Cord Injury Sample. PSYCHOLOGICAL INJURY & LAW 2016. [DOI: 10.1007/s12207-015-9245-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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