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BackgroundTraumatic injury and mental health disorders are co-associated. Early identification of depression, anxiety and stress following injury, and subsequent preventive intervention, may reduce the long-term symptoms and negative impacts associated with depression and anxiety. The purpose of the study was to determine the incidence, severity and predictors of depression, anxiety and stress in injured patients in the acute phase of care, and at six months following injury, as well as the effectiveness of an in-hospital screening tool.MethodsThis descriptive longitudinal study of trauma patients was conducted at a Level 1 Metropolitan Trauma Centre in Australia over 14 months. Participants were interviewed using the Depression Anxiety Stress Scale short-form version (DASS-21) during hospital admission then at 3 and 6 months after injury. Descriptive statistics were performed to evaluate participant characteristics and incidence of depression, anxiety and stress. Correlations and logistic regression were conducted to investigate the ability of the DASS-21 to predict symptoms of depression, anxiety and stress and to investigate factors associated with depression, anxiety and stress 6 months after injury.Results201 participants ranging in age (18–94 years) and injury severity participated in the baseline interview and 109 completed all 3 interviews over 6 months. Over half (54%) reported above normal scores for depression, anxiety and/or stress in at least one of the 3 time points. Intensive care unit admission and high levels of depression, anxiety and stress at 3 months post injury were predictors for high levels of depression, anxiety and stress at 6 months. Low scores for depression, anxiety and stress during admission were correlated with low scores for depression, anxiety and stress at 3 and 6 months.ConclusionDepression, anxiety and stress in patients hospitalised following injury is common and should be anticipated in patients who have had an intensive care admission. Screening at 3 months following injury identifies patients at risk of long-term symptoms of depression, anxiety and stress.

The public image (PI) of nursing, which incorporates beliefs, ideas and impressions that people have of nurses and nursing, has always been a socio-cultural issue for this profession (Emeghebo, 2012, Wallace, 2007. Recently, the environment in which nurses do practice has changed and this change foreshadows significant evolutions in the nursing profession (Maxwell, 2015). There is ample evidence that the PI of nursing has improved globally, especially in developed countries, which holds high value and reputation for the nursing profession. However, there still remains some negative view with regard to the PI of nurses (Meadus & Twomey, 2007;ten-Hoeve et al., 2014). For example, in a recent integrative review, Glerean et al., (2017) found that young people's perceptions of the nursing profession were outdated, partly unrealistic and did not reflect the tasks of a modern nurse. According to the results of this review, these perceptions were largely influenced by social factors such as family and relatives, friends, media and significant

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