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创伤后健康状况。

Health status after traumatic injury.

机构信息

Research Centre for Clinical and Community Practice Innovation, Griffith University and Princess Alexandra Hospital, Queensland, Australia.

出版信息

J Trauma Acute Care Surg. 2012 Jun;72(6):1702-8. doi: 10.1097/TA.0b013e318246bfe9.

Abstract

BACKGROUND

This study explored the relationships between health-related quality of life and postacute factors such as patients' perceived access to information and support, perceptions of illness and ability to provide self-care after traumatic injury.

METHODS

Adults (18 years or older) admitted to hospital for ≥ 24 hours for the acute treatment of trauma in two hospitals in Queensland, Australia, were enrolled in a prospective cohort study. Questionnaires completed at hospital discharge and 3 months and 6 months incorporated the following: demographic data; psychological factors (Revised Illness Perception Questionnaire, Information, Autonomy and Support Scale, and Therapeutic Self-Care Scale); and outcome data (medical short form-36). Data on injury and hospital stay were obtained from health care records and the Queensland Trauma Registry.

RESULTS

One hundred ninety-four patients with a median Injury Severity Score 9 (interquartile range, 5-14) were enrolled, with 125 (64%) completing questionnaires at 6 months. More than half the cohort reported symptoms of pain, fatigue, stiff joints, sleep difficulties, and loss of strength. All subscale scores on the short form-36 were below Australian norms 6 months after injury. Predictors of poor physical health included older age, lower extremity injury, and increased perceived consequences of their injuries, whereas predictors of poor mental health included younger age, female gender, and lower perceived control over their environment.

CONCLUSIONS

Patients with minor to moderate injury based on anatomic injury scoring systems have ongoing challenges with recovery including problematic symptoms and low quality of life. Interventions aimed toward assisting recovery should not be limited to trauma patients with major injury.

LEVEL OF EVIDENCE

Prognostic study, level III.

摘要

背景

本研究探讨了健康相关生活质量与急性后因素之间的关系,如患者对信息和支持的感知获取、对疾病的感知以及创伤后提供自我护理的能力。

方法

澳大利亚昆士兰州两家医院因急性创伤住院治疗至少 24 小时的成年人(18 岁及以上)被纳入前瞻性队列研究。在出院时以及 3 个月和 6 个月时完成的问卷包括以下内容:人口统计学数据;心理因素(修订后的疾病感知问卷、信息、自主和支持量表以及治疗性自我护理量表);以及结局数据(医疗简式 36 项健康调查)。损伤和住院时间的数据来自医疗记录和昆士兰创伤登记处。

结果

共纳入了 194 名损伤严重程度评分中位数为 9 分(四分位间距,5-14)的患者,其中 125 名(64%)在 6 个月时完成了问卷。超过一半的队列报告有疼痛、疲劳、关节僵硬、睡眠困难和力量丧失的症状。在损伤后 6 个月,医疗简式 36 量表的所有子量表评分均低于澳大利亚常模。身体健康不良的预测因素包括年龄较大、下肢损伤和对损伤后果的感知增加,而心理健康不良的预测因素包括年龄较小、女性性别和对环境的感知控制能力较低。

结论

基于解剖损伤评分系统,轻度至中度损伤的患者在康复方面仍面临诸多挑战,包括出现问题的症状和低生活质量。旨在协助康复的干预措施不应仅限于严重损伤的创伤患者。

证据水平

预后研究,III 级。

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