The factors that determine quality of life (QOL) and disability after traumatic injury are poorly understood. This study identified the unique contributions that characteristics about the injury/hospital admission and acute psychological adjustment make in determining 12-month role-related disability and QOL.
Consecutive admissions (n = 363) to a Level I trauma service were assessed just before discharge and followed up at 12 months. Structural equational modeling was used to examine the relationships between the acute factors and 12-month outcomes.
Characteristics of the individual's injuries measured in the acute setting significantly predicted 12-month disability but only indirectly predicted 12-month QOL. An individual's acute psychological response directly predicted both the level of disability and QOL at 12 months.
Both characteristics about an individual's injury and acute psychological responses play important roles in determining later QOL and role-related disability outcomes. Trauma care systems must consider both physical and psychological injury to offer effective and comprehensive healthcare management.
"Hence, both play important roles in determining QoL and disability outcomes (e.g. O'Donnell et al., 2005). Although measures of severity in the second group provide some understanding of the relative seriousness of injuries in terms of threat to life and resource utilization, they still fall short in measuring the long-term impact of non-fatal injuries on the person, his or her family, and the society at large. "
[Show abstract][Hide abstract] ABSTRACT: The objective of this paper is to evaluate the effect of a non-fatal road crash on the health-related quality of life of injured people. A new approach based on the cardinalization of categorical Self-Assessed Health valuations is suggested. Health losses have been estimated by using different Time Trade-off and Visual Analogue Scale tariffs, in order to assess the robustness of the results. The methodology is based on the existing literature about treatment effects. Our main contribution focuses on evaluating the loss of health up to 1 year after the non-fatal accident, for those who are non-institutionalized, which aids the appropriate estimation of the aggregated health losses in quality-of-life terms.
Health Economics 05/2012; 21(5):528-50. DOI:10.1002/hec.1729 · 2.23 Impact Factor
"However, several studies suggest that an individuals' injury and acute psychological responses are strongly linked and so both play important roles in determining quality of life and disability outcomes (e.g. ). Although measures of severity in the second group provide some understanding of the relative seriousness of injuries in terms of threat to life, they still fall short in measuring resource utilization and the long-term impact of nonfatal injuries on the person, his or her family, and society at large. "
[Show abstract][Hide abstract] ABSTRACT: Currently, measures of disability and health-related quality of life are becoming important, even essential, parameters in the evaluation of treatment and prevention strategies for reducing the burden of injury. The estimation of the 'health effect' induced by these policies should incorporate several important aspects: the proper definition of health effect, at individual and aggregate levels; the correct selection of a health metric; the accurate estimation of the short-term effect (direct health gain/loss) and long-term effect (total of health gain/loss throughout the life of the individual) that injuries may produce; and the suitable selection and management of databases. This review article focuses on the particular topic of road crashes, but the analysis can be extended to any sort of injury.
Expert Review of Pharmacoeconomics & Outcomes Research 10/2008; 8(5):471-7. DOI:10.1586/1473718.104.22.1681 · 1.67 Impact Factor
"This pattern is particularly true of our own sample in which less than 50% of individuals with mental health needs received care in the year following their assault (Jaycox et al., 2004). Early intervention in trauma centers has been recommended as a means of preventing the development of PTSD (Zatzick, Russo, Roy-Byrne, Jurkovich, & Katon, 2005). The current findings suggest that these interventions may promote both physical and emotional recovery in at least two ways. "
[Show abstract][Hide abstract] ABSTRACT: This study examines the cross-lagged relationships between posttraumatic distress symptoms and physical functioning, using a sample of 413 persons who were hospitalized for injuries resulting from community violence. Posttraumatic distress was assessed at 1 week, 3 months, and 12 months postinjury, and posttraumatic physical functioning was assessed at 3 months and 12 months. Structural equation modeling was used to assess the prospective relationship between posttraumatic distress symptoms and physical functioning while controlling for demographic characteristics and objective measures of injury severity. Results indicate that posttraumatic distress and physical functioning are reciprocally related. Individuals with high levels of psychological distress at 1 week posttrauma have worse physical functioning at 3 months. Psychological distress at 3 months was not significantly associated with subsequent change in physical functioning at 12 months. Individuals with poor physical functioning at 3 months had higher than expected levels of psychological distress at 12 months. These findings demonstrate a reciprocal relationship between physical and mental health following traumatic injury. Interventions targeting physical recovery may influence subsequent mental health, and therapies aimed at improving early mental health may also have long-term benefits for physical recovery.
Journal of Consulting and Clinical Psychology 09/2008; 76(4):668-76. DOI:10.1037/0022-006X.76.4.668 · 4.85 Impact Factor
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