Whole Assessment of Trauma Recovery-2 (WATR2)

摘要 创伤性损伤是一个重大的公共卫生问题，影响到所有年龄、性别和年龄段的公民。 种族，并负责在44岁及以下的个人死亡最多。公共卫生资源 已经开始处理大规模灾难后的情绪恢复，很少注意到 非灾难相关创伤患者的情绪恢复，而之前患者的感受则更少 需要了解出院时的情绪恢复情况很少有创伤中心会定期为受伤的病人提供 在出院时提供心理支持或信息。出院创伤研究 住院患者，包括我们最近的结构化访谈试点研究，创伤恢复的整体评估-1 （WATR-1），表现出更高的严重抑郁症，创伤后应激障碍（PTSD）， 心理困扰和吸烟相比，一般公众。然而，只有一小部分 那些考虑寻求专业帮助的情绪和心理困扰（EPD）， 得到了帮助。提供以病人为中心的意识，教育和有关情绪健康的转介， 根据以前创伤患者的经验，可能会影响多年的潜在就业和社会 稳定，以及患者的生活质量，并提高医疗质量。 该项目旨在确定创伤患者需要哪些资源来改善他们的恢复后， 释放，以及如何最好地向他们传达这些信息。半结构化开放式电话 对最近出院的病人进行访谈，将使用有目的的样本，以获得 人口统计学和伤害特征，按城市和农村居住地分层。这些采访将是 用于通过以下方式为患者创建新的出院信息：1）了解出院的创伤住院患者 出院后的情感经历，2）征求出院创伤的建议 住院病人关于出院前后的信息，可能是有价值的，在他们的情绪和精神 健康轨迹，以及3）评估心理健康护理后可改变的障碍和促进因素 放电 虽然WATR-1试点研究确定了一些出院后的心理健康需求， 将允许患者自由表达他们认为他们最需要的东西以及如何提供这些东西。 所学到的信息将有助于提高对出院后创伤情感需求的认识， 此外，我们亦会继续为病人提供优质的医疗服务，以及以方便用户的格式，制订和推行以病人为本的出院资料。 新的出院形式可能涉及诸如用于教育的交互式智能手机应用程序等技术 和监测。未来的研究可以从心理健康的角度评估随后的患者结果， 生活质量和功能恢复。通过更全面地帮助创伤患者获得最大限度的 功能，这个项目不仅可以影响病人的结果，但他们的家庭和社会。

ABSTRACT Traumatic injuries are a significant public health issue, affecting citizens of all ages, genders, and races, and responsible for the most deaths in individuals 44 years and younger. While public health resources have begun to address emotional recovery after large scale disasters, little attention has been paid to the emotional recovery of non-disaster-related trauma patients, and less still to what previous patients feel they needed to know about emotional recovery at discharge. Few trauma centers routinely provide injured patients with psychological support or information at discharge from the hospital. Research with discharged trauma inpatients, including our recent pilot study of structured interviews, Whole Assessment of Trauma Recovery-1 (WATR-1), demonstrated higher rates of major depression, posttraumatic stress disorder (PTSD), psychological distress, and smoking when compared to the general public. Yet only a small percentage of those who considered seeking professional help for emotional and psychological distress (EPD) actually received help. Providing patient-centered awareness, education, and referral regarding emotional health, based on the experiences of previous trauma patients, could affect years of potential employment and social stability, as well as quality of life of the patients, and improve health care quality. This project aims to identify what resources trauma patients need to improve their recovery after discharge, and how best to communicate this information to them. Semi-structured, open-ended telephone interviews with recently discharged patients will be conducted using a purposive sample to obtain a mix of demographic and injury characteristics, stratified by urban versus rural residence. These interviews will be used to create new discharge information for patients by: 1) Learning what discharged trauma inpatients experienced emotionally after discharge, 2) Soliciting recommendations from discharged trauma inpatients about peri-discharge information that may have been valuable in their emotional and mental health trajectory, and 3) Assessing modifiable barriers and facilitators to mental health care after discharge. While the WATR-1 pilot study identified some post-discharge mental health needs, this research project would allow patients the freedom to voice what they believe they most need and how to provide it. The information learned will serve to both increase awareness of the post-discharge emotional needs of trauma patients, as well as to develop and implement patient-oriented discharge materials in user-friendly formats. The new discharge format may involve technology such as interactive smart phone applications for education and monitoring. Future research could then evaluate the ensuing patient outcomes in terms of mental health, quality of life, and return to function. By more completely assisting trauma patients in obtaining maximum function, this project could affect not only patient outcome, but that of their families and society.