Mental health problems and admissions to hospital for accidents and injuries in the UK military: A data linkage study.
Mental health problems and admissions to hospital for accidents and injuries in the UK military: A data linkage study.
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在英国军方的心理健康问题和送往医院的事故和伤害：一项数据联系研究。
DOI：
10.1371/journal.pone.0280938
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
Goodwin, Laura
中科院分区：
文献类型：
--
作者：
Chui, Zoe;Leightley, Daniel D.;Jones, Margaret;Landau, Sabine T.;McCrone, Paul;Hayes, Richard;Wessely, Simon;Fear, Nicola;Goodwin, Laura
事故是英国军人死亡的最常见原因。公众普遍误解意外伤害总是随机事件的结果，但研究表明，心理健康问题和军事人员危险行为水平的增加可能起作用。本研究的目的是通过检查心理健康、酗酒和吸烟与因事故和伤害住院以及参加事故和紧急（A&E）部门的关系，进一步了解与部署无关的伤害和死亡。在英格兰、苏格兰和威尔士的NHS医院，所有因事故和伤害入院的数据以及A&E就诊的数据与一个大型的、有代表性的英国现役和退役军人队列（n = 8，602）的自我报告的心理健康问题、酒精滥用和吸烟的数据相关联。Logistic回归分析被用来研究因事故或伤害入院与自我报告的精神健康问题，酗酒和吸烟之间的关系。然后进行考克斯比例风险回归，以评估心理健康问题、酗酒和吸烟与因事故或伤害入院时间的关系。最后，负二项回归被用来检查与精神健康问题，酒精滥用和吸烟的A&E就诊人数之间的关联。报告普通精神障碍（CMD）或可能的创伤后应激障碍（PTSD）症状的人员更有可能因事故或受伤而入院（完全校正的比值比1.39，95%置信区间[CI] 1.05-1.84），比那些没有报告这些症状，而急症室的求诊人次亦较多（经完全校正的发病率比率[IRR]为1.32，95% CI为1.16-1.51）。在调整人口统计学、军事和健康特征后，吸烟人员的急诊就诊率也更高（完全调整后的IRR 1.21，95% CI 1.09-1.35）。调查结果表明，军事人员的事故和受伤并不总是随机事件，还有健康和行为因素，包括心理健康状况差和吸烟，这些因素与事故风险增加有关（影响较小）。在事故发生后治疗住院患者的临床医生应全面考虑他们的医疗保健需求，包括与心理健康和损害健康行为有关的问题。
Accidents are the most common cause of death among UK military personnel. It is a common misconception in the general public that accidental injuries are always the result of random events, however research suggests that mental health problems and the increased levels of risky behaviour in military personnel may play a role. The objective of this study was to further our understanding of injuries and deaths not related to deployment by examining the associations of mental health, alcohol misuse and smoking with inpatient admission to hospital for accidents and injuries, and attendance to accident and emergency (A&E) departments. Data on all hospital admissions for accidents and injuries and A&E attendance at NHS hospitals in England, Scotland and Wales were linked to data on self-reported mental health problems, alcohol misuse and smoking from a large, representative UK military cohort of serving and ex-serving personnel (n = 8,602). Logistic regression was used to examine the associations between having a hospital admission for an accident or injury with self-reported mental health problems, alcohol misuse and smoking. Cox proportional-hazards regression was then conducted to assess the associations of mental health problems, alcohol misuse and smoking with time to hospital admission for an accident or injury. Finally, negative binomial regression was used to examine associations between the number of A&E attendances with mental health problems, alcohol misuse and smoking. Personnel reporting symptoms of common mental disorder (CMD) or probable post-traumatic stress disorder (PTSD) were more likely to have an admission to hospital for an accident or injury (fully adjusted odds ratio 1.39, 95% confidence interval [CI] 1.05–1.84), than those who did not report these symptoms, and also had more attendances to A&E (fully adjusted incidence rate ratio [IRR] 1.32, 95% CI 1.16–1.51). A&E attendances were also more common in personnel who were smokers (fully adjusted IRR 1.21, 95% CI 1.09–1.35) following adjustment for demographic, military and health characteristics. The findings suggest that accidents and injuries among military personnel are not always random events and that there are health and behavioural factors, including poor mental health and smoking, which are associated (with small effect sizes) with an increased risk of being involved in an accident. Clinicians treating individuals attending hospital after an accident should consider their healthcare needs holistically, including issues related to mental health and health damaging behaviours.
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影响因子：
4.9
作者：
Leightley D;Chui Z;Jones M;Landau S;McCrone P;Hayes RD;Wessely S;Fear NT;Goodwin L
通讯作者：
Goodwin L
影响因子：
3.7
作者：
Dare S;Mackay DF;Pell JP
通讯作者：
Pell JP
影响因子：
1.2
作者：
Bray, Robert M.;Pemberton, Michael R.;Babeu, Lorraine A.
通讯作者：
Babeu, Lorraine A.
影响因子：
4.2
作者：
Gerrard, M;Gibbons, FX;Hessling, RM
通讯作者：
Hessling, RM
影响因子：
3.4
作者：
Bonn-Miller, Marcel O.;Vujanovic, Anka A.;Drescher, Kent D.
通讯作者：
Drescher, Kent D.