Patients Follow Different Financial Hardship Trajectories in the Year after Injury.
Patients Follow Different Financial Hardship Trajectories in the Year after Injury.
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患者在受伤后一年内经历不同的经济困难轨迹。
DOI：
10.1097/sla.0000000000005432
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发表时间：
2022
影响因子：
9
通讯作者：
Zarzaur,BenL
中科院分区：
文献类型：
--
作者：
Nishtala,MadhuriV;Robbins,SarahE;Savage,Stephanie;Timsina,LavaR;Murphy,PatrickB;Marka,NicholasA;Venkatesh,Manasa;Zarzaur,BenL
目的：确定是否存在不同的财务轨迹以及它们是否与生活质量结果相关。背景数据摘要：受伤后的财务困难会显着影响与健康相关的生活质量结果。经济困难，包括物质损失、财务担忧和不良应对机制，与生活质量下降和心理困扰加剧有关。然而，恢复是动态的，经济困难可能会随着时间的推移而改变。方法：这是对 500 名中度至重度非神经系统损伤患者的二次分析，其中使用调查工具（Short Form-36）在受伤后 1、2、4 和 12 个月测量经济困难和健康相关的生活质量结果。 2009 年 1 月至 2011 年 12 月期间，在田纳西州孟菲斯市的一个城市学术一级创伤中心进行了招募，并于 2012 年 12 月完成了随访。 结果：474 名患者拥有足够的数据进行基于组的轨迹分析。确定了四种不同的经济困难轨迹： 经济有保障的患者 (8.6%) 随着时间的推移始终处于较低的困难水平；经济上遭受重创的患者在受伤后立即陷入高度困难，并且从未康复（51.6%）；随着时间的推移，经济虚弱的患者的困难越来越大（33.6%）；经济上有弹性的患者一开始非常困难，但到年底就康复了（6.2%）。与美国人口标准相比，12 个月时，所有轨迹的 Short Form-36 身体成分得分都很差，财务脆弱和财务受损轨迹的心理健康得分也很差。结论和相关性：财务弹性轨迹表明受伤后的财务困难是可以克服的。需要进一步研究以了解这种情况发生的原因和方式。
Objective:To determine if distinct financial trajectories exist and if they are associated with quality-of-life outcomes.Summary of Background Data:Financial hardship after injury measurably impacts Health-Related Quality of Life outcomes. Financial hardship, encompassing material losses, financial worry, and poor coping mechanisms, is associated with lower quality of life and increased psychological distress. However, recovery is dynamic and financial hardship may change over time.Methods:This is a secondary analysis of a cohort of 500 moderate-to-severe nonneurologic injured patients in which financial hardship and Health-related Quality of Life outcomes were measured at 1, 2, 4, and 12 months after injury using survey instruments (Short Form-36). Enrollment occurred at an urban, academic, Level 1 trauma center in Memphis, Tennessee during January 2009 to December 2011 and follow-up completed by December 2012.Results:Four hundred seventy-four patients had sufficient data for Group-Based Trajectory Analysis. Four distinct financial hardship trajectories were identified: Financially Secure patients (8.6%) had consistently low hardship over time; Financially Devastated patients had a high degree of hardship immediately after injury and never recovered (51.6%); Financially Frail patients had increasing hardship over time (33.6%); and Financially Resilient patients started with a high degree of hardship but recovered by year end (6.2%). At 12-months, all trajectories had poor Short Form-36 physical component scores and the Financial Frail and Financially Devastated trajectories had poor mental health scores compared to US population norms.Conclusions and Relevance:The Financially Resilient trajectory demonstrates financial hardship after injury can be overcome. Further research into understanding why and how this occurs is needed.