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Health status after traumatic injury

Aitken, Leanne M. RN, PhD; Chaboyer, Wendy RN, PhD; Kendall, Elizabeth PhD; Burmeister, Elizabeth RN, MSc

Journal of Trauma and Acute Care Surgery: June 2012 - Volume 72 - Issue 6 - p 1702–1708
doi: 10.1097/TA.0b013e318246bfe9
Original Articles

BACKGROUND: This study explored the relationships between health-related quality of life and postacute factors such as patients’ perceived access to information and support, perceptions of illness and ability to provide self-care after traumatic injury.

METHODS: Adults (18 years or older) admitted to hospital for ≥24 hours for the acute treatment of trauma in two hospitals in Queensland, Australia, were enrolled in a prospective cohort study. Questionnaires completed at hospital discharge and 3 months and 6 months incorporated the following: demographic data; psychological factors (Revised Illness Perception Questionnaire, Information, Autonomy and Support Scale, and Therapeutic Self-Care Scale); and outcome data (medical short form-36). Data on injury and hospital stay were obtained from health care records and the Queensland Trauma Registry.

RESULTS: One hundred ninety-four patients with a median Injury Severity Score 9 (interquartile range, 5–14) were enrolled, with 125 (64%) completing questionnaires at 6 months. More than half the cohort reported symptoms of pain, fatigue, stiff joints, sleep difficulties, and loss of strength. All subscale scores on the short form-36 were below Australian norms 6 months after injury. Predictors of poor physical health included older age, lower extremity injury, and increased perceived consequences of their injuries, whereas predictors of poor mental health included younger age, female gender, and lower perceived control over their environment.

CONCLUSIONS: Patients with minor to moderate injury based on anatomic injury scoring systems have ongoing challenges with recovery including problematic symptoms and low quality of life. Interventions aimed toward assisting recovery should not be limited to trauma patients with major injury.

LEVEL OF EVIDENCE: Prognostic study, level III.

From the Research Centre for Clinical and Community Practice Innovation (L.M.A.), Griffith University and Princess Alexandra Hospital; NHMRC Centre for Research Excellence in Nursing Interventions for Hospitalised Patients (NCREN) (W.C.), Griffith University; Centre of National Research on Disability and Rehabilitation and Centre for Population and Community Health (E.K.), Griffith University; and Research Centre for Clinical and Community Practice Innovation (E.B.), Griffith University and Princess Alexandra Hospital, Queensland, Australia.

Submitted: August 23, 2011, Revised: December 8, 2011, Accepted: December 14, 2011.

Supported by the Centre of National Research on Disability and Rehabilitation Medicine (CONROD) Collaborative Grants Scheme, Brisbane, Australia.

Presented, orally, at the Australian Health & Medical Research Conference, December4–5, 2008, Brisbane, Australia.

Address for reprints: Leanne M. Aitken, PhD, Nursing Practice Development Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland 4102, Australia; email: l.aitken@griffith.edu.au.

© 2012 Lippincott Williams & Wilkins, Inc.