School of Public Health and Preventive Medicine.
Rehabil Psychol. 2022 Aug;67(3):405-420. doi: 10.1037/rep0000453. Epub 2022 Jun 16.
Purpose/Objective Research: This study aimed to examine patterns of pain and mental health after injury, and the patient characteristics associated with reductions in those symptoms.
RESEARCH METHOD/DESIGN: This registry-based observational cohort study included all people ≥ 16 years old hospitalized for unintentional injuries from 2007 to 2014 who were included in the Victorian State Trauma Registry or Victorian Orthopaedic Trauma Outcomes Registry, survived to 12-months postinjury and did not have severe brain injury or spinal cord injury ( = 31,073). Symptoms and related impacts were measured with pain Numerical Rating Scale, EuroQol Five Dimensions Three Level questionnaire (EQ-5D-3L), and 12-item Short Form Health Survey (SF-12) pain and mental health items at 6-, 12-, and 24-months postinjury. Symptom patterns over time, and their predictors, were examined using Latent Class and Transition Analyses and multinomial logistic regression.
Four classes were identified: (1) Low pain and mental health problems (49-54%); (2) mental health problems only (11-12%); (3) pain problems only (18-23%); and (4) pain and mental health problems (16-17%). Most people stayed within the same class over time, or transitioned to fewer problems. People who transitioned to lower problems had higher socioeconomic status (e.g., higher education level, higher neighborhood-level advantage, and employment), better preinjury health (e.g., no disability or substance use condition) and noncompensable injuries.
CONCLUSION/IMPLICATIONS: Reduced pain and mental health symptoms and related impairments were primarily associated with nonmodifiable biological, social, or economic characteristics. People with persistent symptoms were often already living with social disadvantage preinjury, and may have benefited from risk screening and proactive interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
本研究旨在探讨损伤后疼痛和心理健康的模式，以及与这些症状减轻相关的患者特征。
研究方法/设计：本基于登记的观察性队列研究纳入了 2007 年至 2014 年期间因意外伤害住院的所有年龄≥16 岁的患者，这些患者被纳入维多利亚州创伤登记处或维多利亚州骨科创伤结局登记处，在损伤后 12 个月存活且无严重脑损伤或脊髓损伤（=31073）。症状及相关影响通过疼痛数字评分量表、欧洲五维健康量表（EQ-5D-3L）和 12 项简明健康调查问卷（SF-12）疼痛和心理健康项目在损伤后 6、12 和 24 个月进行测量。使用潜在类别和转换分析以及多项逻辑回归分析来检查随时间变化的症状模式及其预测因素。
确定了四个类别：（1）低疼痛和心理健康问题（49-54%）；（2）仅心理健康问题（11-12%）；（3）仅疼痛问题（18-23%）；和（4）疼痛和心理健康问题（16-17%）。大多数人随着时间的推移仍处于同一类别，或向问题较少的类别转移。向较低问题类别转移的人具有较高的社会经济地位（例如，较高的教育水平、较高的邻里优势和就业）、更好的受伤前健康状况（例如，无残疾或物质使用状况）和不可赔偿的损伤。
结论/意义：疼痛和心理健康症状及相关损伤的减轻主要与不可改变的生物、社会或经济特征相关。持续存在症状的患者通常在受伤前已经处于社会劣势地位，可能受益于风险筛查和主动干预。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
