Physical effects of trauma and the psychological consequences of preexisting diseases account for a significant portion of the health-related quality of life patterns of former trauma patients

Orwelius, Lotti; Bergkvist, Max; Nordlund, Anders; Simonsson, Eva; Nordlund, P.; Bäckman, Carl; Sjöberg, Folke

doi:10.1097/ta.0b013e31821a416a

Cited by 24 publications

(20 citation statements)

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“…The remainder were retrospective studies (n = 6751). Collectively the studies were conducted in different countries and continents: Seven in the USA [29]–[35]; six in Australasia (four in Australia and two in New Zealand) [36]–[41]; 19 in Europe (five in Germany [27], [42]–[45], four each in The Netherlands [46]–[49] and Norway [8], [9], [50], [51], two each in the UK [24], [25] and Sweden [28], [52], one each in Switzerland [53], Denmark [26] and one each in Israel [54] and South Africa [55] (Table 1, Table S3). …”

Section: Resultsmentioning

confidence: 99%

Health Outcome after Major Trauma: What Are We Measuring?

et al. 2014

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ImportanceTrauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.ObjectiveTo systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.Data SourcesMEDLINE, EMBASE, and CINAHL (from 2006–2012) were searched for studies evaluating health outcome after traumatic injuries.Study selection and data extractionStudies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts.Results34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%).ConclusionOutcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

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Section: Resultsmentioning

confidence: 99%

Health Outcome after Major Trauma: What Are We Measuring?

et al. 2014

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“…Indeed, previous studies found that physical wellbeing was further decreased after the trauma than mental wellbeing 5;8 but that the overall decrease in HRQOL remained and primarily had a psychological basis. 5 Future studies should follow patients over time to determine how physical limitations and psychological complaints develop over time while investigating how these factors influence each other.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that the (HR)QOL of severely injured patients is lower than that of the general population. [2][3][4][5][6][7][8] This decrease in (HR)QOL seems to depend on both psychological complaints and physical limitations, but few studies measured these three parameters within the same study population.…”

Section: Introductionmentioning

confidence: 99%

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

Delft-Schreurs

Son²,

Jongh

et al. 2017

Injury

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

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“…Several studies have found psychological problems after injury can have a greater impact on quality of life than the physical injury [4, 10, 17, 18] and impairments to quality of life can persist after resolution of the psychological symptoms [19]. Few studies have focussed on the relationship between psychological morbidity and quality of life after injury amongst general injury populations, including those with minor and more major injuries [4, 16, 20, 21]. Identifying and managing psychological problems are recognised as an important component of UK post-injury care for major trauma [22] or for specific injuries such as burns [23], head injuries [24] or spinal cord injuries [25].…”

Section: Introductionmentioning

confidence: 99%

Psychological morbidity and health-related quality of life after injury: multicentre cohort study

et al. 2016

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Purpose To demonstrate the impact of psychological morbidity 1 month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in the UK to inform development of trauma care and rehabilitation services.Methods Multicentre cohort study of 16–70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at recruitment and 1, 2, 4 and 12 months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity 1 month post-injury and MID in HRQoL over the 12 months after injury.ResultsA total of 668 adults participated. Follow-up rates were 77% (1 month) and 63% (12 months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1 month and 58% at 12 months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1 month post-injury were independently associated with subsequent MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship between anxiety and HRQoL was not explained by factors measured in our study.ConclusionsHospitalised injuries result in substantial reductions in HRQoL up to 12 months later. Depression and anxiety early in the recovery period are independently associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving HRQoL post-injury.Electronic supplementary materialThe online version of this article (doi:10.1007/s11136-016-1439-7) contains supplementary material, which is available to authorized users.

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Physical effects of trauma and the psychological consequences of preexisting diseases account for a significant portion of the health-related quality of life patterns of former trauma patients

Abstract: Background

Cited by 24 publications

References 30 publications

Health Outcome after Major Trauma: What Are We Measuring?

Health Outcome after Major Trauma: What Are We Measuring?

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

Psychological morbidity and health-related quality of life after injury: multicentre cohort study

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