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 种族，在44岁及以下的人中死亡人数最多。虽然公共卫生资源 已经开始处理大规模灾难后的情绪恢复，但很少有人关注 非灾难相关创伤患者的情绪恢复，更少恢复到以前患者的感受 需要知道出院时的情绪恢复情况。很少有创伤中心例行公事地提供受伤患者 出院时有心理支持或信息。关于出院创伤的研究 住院患者，包括我们最近的结构化访谈的试点研究，创伤恢复的整体评估-1 (WATR-1)，显示出较高的严重抑郁症、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 那些考虑为情绪和心理困扰寻求专业帮助的人实际上 收到了帮助。提供以患者为中心的情绪健康意识、教育和转介， 根据以前创伤患者的经验，可能会影响几年的潜在就业和社会 稳定以及患者的生活质量，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康复 出院，以及如何最好地向他们传达这一信息。半结构化、开放式电话 访问最近出院的病人将使用有目的的样本，以获得混合的 人口统计和伤害特征，按城市和农村住宅分层。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)了解哪些出院创伤住院患者 出院后的情感体验，2)从出院的创伤中寻求建议 住院患者关于出院期间的信息，这些信息可能对他们的情绪和心理有价值 健康轨迹，以及3)评估可修改的障碍和精神卫生保健的促进者 出院。 虽然WATR-1试点研究确定了出院后的一些心理健康需求，但这项研究项目 将允许患者自由表达他们认为自己最需要的东西以及如何提供。这个 学习到的信息将有助于提高对出院后创伤的情感需求的认识 以患者为中心，并以用户友好的形式开发和实施以患者为导向的出院材料。 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等技术 并进行监控。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，回归功能。通过更全面地帮助创伤患者获得最大 这个项目不仅可以影响患者的预后，还可以影响他们的家庭和社会的预后。

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.