Financial and recovery worry one year after traumatic injury: A prognostic, registry-based cohort study
Financial and recovery worry one year after traumatic injury: A prognostic, registry-based cohort study
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DOI：
10.1016/j.injury.2018.03.013
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发表时间：
2018-05-01
影响因子：
2.5
通讯作者：
Giummarra, M. J.
中科院分区：
文献类型：
--
作者：
Ioannou, L.;Cameron, P. A.;Giummarra, M. J.
背景：受伤后的压力水平，特别是在可补偿的伤害之后，已知与更差的长期恢复相关。因此，重要的是要确定如何，以及在谁，担心和压力表现受伤后。本研究的目的是确定人口统计学，伤害和补偿因素与担心的财务和恢复的结果12个月后创伤injure.Methods：参与者（n = 433）被招募从维多利亚州骨科创伤结局登记处和维多利亚州创伤登记处入院后，在澳大利亚墨尔本的一家大型创伤医院。参与者完成了问卷调查的疼痛，补偿经验和心理健康的一部分，注册为基础的observational study.Results：线性回归显示，人口和伤害因素分别占11%和13%的方差在财务和恢复的担忧。具体来说，较低的教育，出院到住院康复，归咎于错误的另一个和有赔偿要求预测经济上的担忧。只有住院时间更长和归咎于他人才能预测对康复的担忧。在所有参与者中，财务和恢复担忧与受伤后12个月的疼痛（严重程度，干扰，灾难化，运动恐惧症，自我效能），身体（残疾，功能）和心理（焦虑，抑郁，创伤后应激障碍，感知不公正）结果相关。在有交通（n = 135）或工作（n = 22）伤害赔偿索赔的参与者中，财务和恢复方面的担忧都与持续的永久性损伤有关，并报告了受伤后12个月的负面赔偿制度经验。财务担心12个月后受伤与不返回工作3-6个月后受伤，而恢复担心与归因于故障到另一个，和更高的医疗保健使用在6-12个月post-injure.Conclusions：这些研究结果突出了重要的贡献的因素，而不是受伤的严重程度，担心财务和恢复伤后。索赔、无法重返工作岗位、经历疼痛和心理症状也会导致担忧加剧。然而，由于这些因素只能解释不到一半的担忧方差，因此本研究中未测量的其他因素肯定也发挥了作用。由于担心可能会增加发生继发性心理健康状况的风险，因此应向受伤后无法应对的人提供及时的经济、康复和心理支持。(C)2018爱思唯尔有限公司版权所有。
Background: Levels of stress post-injury, especially after compensable injury, are known to be associated with worse long-term recovery. It is therefore important to identify how, and in whom, worry and stress manifest post-injury. This study aimed to identify demographic, injury, and compensation factors associated with worry about financial and recovery outcomes 12 months after traumatic injury.Methods: Participants (n = 433) were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry after admission to a major trauma hospital in Melbourne, Australia. Participants completed questionnaires about pain, compensation experience and psychological wellbeing as part of a registry-based observational study.Results: Linear regressions showed that demographic and injury factors accounted for 11% and 13% of variance in financial and recovery worry, respectively. Specifically, lower education, discharge to inpatient rehabilitation, attributing fault to another and having a compensation claim predicted financial worry. Worry about recovery was only predicted by longer hospital stay and attributing fault to another. In all participants, financial and recovery worry were associated with worse pain (severity, interference, catastrophizing, kinesiophobia, self-efficacy), physical (disability, functioning) and psychological (anxiety, depression, PTSD, perceived injustice) outcomes 12 months post-injury. In participants who had transport (n = 135) or work (n = 22) injury compensation claims, both financial and recovery worry were associated with sustaining permanent impairments, and reporting negative compensation system experience 12 months post-injury. Financial worry 12 months post-injury was associated with not returning to work by 3-6 months post-injury, whereas recovery worry was associated with attributing fault to another, and higher healthcare use at 6-12 months post-injury.Conclusions: These findings highlight the important contribution of factors other than injury severity, to worry about finances and recovery post-injury. Having a compensation claim, failure to return to work and experiencing pain and psychological symptoms also contribute to elevated worry. As these factors explained less than half of the variance in worry, however, other factors not measured in this study must play a role. As worry may increase the risk of developing secondary mental health conditions, timely access to financial, rehabilitation and psychological supports should be provided to people who are not coping after injury. (C) 2018 Elsevier Ltd. All rights reserved.