Institute for Social Neuroscience, ISN Psychology, Ivanhoe, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Disabil Rehabil. 2022 Dec;44(25):8029-8041. doi: 10.1080/09638288.2021.2008526. Epub 2021 Dec 6.
This study aimed to characterise recovery from pain and mental health symptoms, and identify whether treatment use facilitates recovery.
Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry participants without neurotrauma who had transport injury claims with the Transport Accident Commission from 2007 to 2014 were included ( = 5908). Latent transition analysis of pain Numeric Rating Scale, SF-12, and EQ-5D-3L pain and mental health items from 6 to 12 months, and 12 to 24 months post-injury were used to identify symptom transitions.
Four transition groups were identified: transition to low problems by 12-months; transition to low problems at 24-months; stable low problems; and no transition from problems. Group-based trajectory modelling of pain and mental health treatments found three treatment trajectories: low/no treatment, a moderate treatment that declined to low treatment 3-12 months post-injury, and increasing treatment over time. Predictors of pain and mental health recovery transitions, identified using multinomial logistic regression, were primarily found to be non-modifiable socioeconomic and health-related characteristics (e.g., higher education, working pre-injury, and not having comorbidities), and low treatment trajectories.
Targeted and collaborative rehabilitation should be considered for people at risk of persistent pain or mental health symptoms to optimise their recovery, particularly patients with socioeconomic disadvantage.IMPLICATIONS FOR REHABILITATIONTwo-thirds of people experience pain and/or mental health within the first 24-months after hospitalization for road trauma, of whom only 6-7% recover by 12-months, and a further 6% recover by 24-months post-injury.There were three main trajectories of administrative records of treatments received in the first two years after injury: 76 and 83% had low treatment, 18 and 12% had moderate then declining treatment levels, and 6 and 5% had stable high treatment for pain or mental health, respectively.People who recovered from pain or mental health symptoms generally had lower treatment and higher socioeconomic position, highlighting that coordinated rehabilitation care should be prioritized for people living with socioeconomic disadvantage.
本研究旨在描述疼痛和心理健康症状的恢复情况，并确定治疗的使用是否有助于康复。
纳入了 2007 年至 2014 年期间无神经创伤、在维多利亚州创伤登记处和维多利亚州矫形创伤结局登记处登记且因交通伤向运输事故委员会提出索赔的无神经创伤的患者（共 5908 例）。采用潜伏转变分析方法对伤后 6-12 个月和 12-24 个月时疼痛数字评分量表、SF-12 量表和 EQ-5D-3L 疼痛和心理健康项目进行分析，以确定症状的转变情况。
共确定了 4 个转变组：12 个月时疼痛和心理健康问题转为低水平；24 个月时疼痛和心理健康问题转为低水平；稳定的低水平问题；无问题转变。对疼痛和心理健康治疗的基于群组的轨迹建模发现了 3 种治疗轨迹：低/无治疗，伤后 3-12 个月逐渐减少至低治疗的中等治疗，以及随时间推移逐渐增加的治疗。使用多项逻辑回归分析确定了疼痛和心理健康恢复转变的预测因素，主要是不可改变的社会经济和健康相关特征（例如，较高的教育水平、受伤前工作和无合并症）和低治疗轨迹。
对于有持续疼痛或心理健康症状风险的患者，应考虑有针对性和协作性的康复治疗，以优化其康复效果，特别是对于处于社会经济劣势的患者。
三分之二的人在因道路创伤住院后的头 24 个月内出现疼痛和/或心理健康问题，其中只有 6-7%的人在 12 个月时康复，6%的人在伤后 24 个月时康复。伤后两年内接受治疗的行政记录有三种主要轨迹：76%和 83%的人接受低水平治疗，18%和 12%的人接受中等水平然后逐渐减少的治疗水平，6%和 5%的人接受稳定高水平的疼痛或心理健康治疗。从疼痛或心理健康症状中恢复的患者通常接受的治疗较少，社会经济地位较高，这表明应优先考虑为处于社会经济劣势的人群提供协调的康复护理。
