Wegener Stephen T, Pollak Andrew N, Frey Katherine P, Hymes Robert A, Archer Kristin R, Jones Clifford B, Seymour Rachel B, OʼToole Robert V, Castillo Renan C, Huang Yanjie, Scharfstein Daniel O, MacKenzie Ellen J
*Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD; †R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD; ‡Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; §Inova Fairfax Medical Campus, Department of Orthopaedic Surgery, Orthopaedic Trauma, Fairfax, VA; ‖Department of Orthopaedic Surgery and Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN; ¶The CORE Institute, University of Arizona Medical College - Phoenix, Banner University Medical Center, Phoenix, AZ; **Carolinas Medical Center, Department of Orthopaedic Surgery, Charlotte, NC; and ††Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
J Orthop Trauma. 2017 Apr;31 Suppl 1:S78-S87. doi: 10.1097/BOT.0000000000000792.
Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers. The TCC program was evaluated by comparing outcomes of patients treated at 6 intervention sites (n = 481) with 6 trauma centers where care was delivered as usual (control sites, n = 419). Compared with standard treatment alone, it is hypothesized that access to the TCC program plus standard treatment will result in lower rates of poor patient-reported function, depression, and posttraumatic stress disorder.
先前的研究表明，通过对情绪困扰和心理合并症进行早期筛查和管理，可以改善对创伤患者的护理。创伤协作护理（TCC）项目基于成熟的协作护理模式原则设计，旨在弥补创伤中心护理的这一空白。本文介绍了TCC项目以及一项多中心研究的设计，该研究旨在评估其在一级创伤中心对严重高能骨科创伤患者改善预后的有效性。通过比较6个干预地点（n = 481）接受治疗的患者与6个照常提供护理的创伤中心（对照地点，n = 419）的患者的结局，对TCC项目进行评估。与单纯的标准治疗相比，假设接受TCC项目加标准治疗将导致患者报告的功能不佳、抑郁和创伤后应激障碍的发生率降低。
