The psychosocial consequences of traumatic injury

Abstract

Long-term stress experienced by trauma patients was assessed for a sample of 137 patients treated at a large urban trauma center after suffering traumatic injuries resulting from motor vehicle/motorcycle accidents, falls, pedestrian accidents, and stabbing and gunshot wounds. Levels of psychological distress reported 3 to 39 months after the accident were considerable, but a measure of injury severity commonly used in critical care settings was not a good predictor of psychosocial outcome. The subjective impact of the accident and injury-related financial and employment problems were more important in predicting outcome than medical variables or time since injury. Family environment ratings were significantly worse for subjects with elevated levels of psychiatric symptoms. The results suggest that psychosocial interventions may benefit many of these individuals. Aspects to be considered in planning the intervention include projected functional disability, likely employment and financial problems, subjective perceptions of the accident and its implications, and family and social support.

Improving recovery—Learning from patients’ experiences after injury: A qualitative study

“…26 This research confirms the importance of social support for facilitating recovery from injury. [27][28][29] Support from friends, family and neighbours was regarded by participants as extremely important especially during the first few weeks/months after leaving hospital. This is when many were incapacitated and simple everyday tasks were difficult, or for some impossible to achieve.…”

Evaluation of post traumatic distress in the first 6 months following SCI

“…In a study of 137 people who had severe injuries resulting from road accidents, falls, pedestrian accidents, stabbings and gunshot wounds, Landsman 6 found a high level of intrusive images and memories and psychiatric symptomatology. Church and Vincent 7 found in their sample of 29 individuals who had su ered a medical accident that 50% had clinically relevant levels of intrusion and 32% avoidance.…”

The psychosocial consequences of motor vehicle accidents

“…Malt et al found that 19% of people who were accidentally injured (most in MVAs) reported a major decline in their psychological health following the accident. Similarly, it has been found that 40% of traumatically injured individuals exhibit clinically elevated scores on the Brief Symptom Inventory (Landsman et al, 1990)) exceeding normative levels of depression, anxiety, hostility, somatization, and obsessivecompulsive disorders. Children involved in MVAs have demonstrated similar symptomatology (Jaworowski, 1992), including separation difficulties, excessive fear, agitation, aggression, and suicidal behavior.…”

“…The loss of paid employment, or even a reduction in vocational status to a lower level of remuneration or to part-time employment, can be financially devastating, particularly for young people with families. Indeed, more than 30% of a sample of people injured in MVAs indicated that they had experienced a major reduction in income as a result of their injury (Landsman et al, 1990). In terms of the broad economy, the finan-58 E. Kendall and N .…”

“…When one considers the fact that the majority of MVA survivors are young men for whom work is an integral component of their self-concept and identity (Colling, 1992), it is clear that vocational loss is also likely to have profound psychological and emotional ramifications. Indeed, it has been found that people who are unable to return to work following an accident evidence higher levels of psychiatric disorder than those who are able to return to work (Landsman et al, 1990). However, the social impact of lost employment can be extremely pervasive, particularly since work is one of the primary means by which social integration occurs.…”