Leidos, Inc., San Diego, CA, USA.
Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA.
Qual Life Res. 2023 Feb;32(2):461-472. doi: 10.1007/s11136-022-03263-3. Epub 2022 Oct 27.
Posttraumatic stress disorder (PTSD) and depression are strong predictors of poor health-related quality of life (HRQOL) among injured U.S. military service members (SMs). Patterns of HRQOL between injury categories and injury categories stratified by mental health (MH) symptoms have not been examined. Among deployment-injured SMs and veterans (n = 4353), we examined HRQOL and screening data for PTSD and/or depression within specific injury categories.
Participants included those enrolled in the Wounded Warrior Recovery Project with complete data for HRQOL (SF-36) from June 2017 to May 2020. Injuries were categorized using the Barell Injury Diagnosis Matrix (Barell Matrix). Mean physical component summary (PCS) and mental component summary (MCS) scores were calculated for each injury category and stratified by the presence or absence of probable PTSD and/or depression.
The average follow-up time that participants were surveyed after injury was 10.7 years. Most participants were male, non-Hispanic White, served in the Army, and enlisted rank. Mechanism of injury for 77% was blast-related. Mean PCS and MCS scores across the entire sample were 43.6 (SD = 10.3) and 39.5 (SD = 13.3), respectively; 50% screened positive for depression and/or PTSD. PCS and MCS scores were significantly lower within each injury category among individuals with probable PTSD and/or depression than those without.
Among deployment-injured SMs, those with probable PTSD and/or depression reported significantly lower HRQOL within injury categories and HRQOL component (i.e., physical or mental) than those without. Findings are consistent with prior reports showing mental health symptoms to be strongly associated with lower HRQOL and suggest integration of mental health treatment into standard care practices to improve long-term HRQOL.
创伤后应激障碍（PTSD）和抑郁是美国受伤军人（SM）健康相关生活质量（HRQOL）较差的有力预测因素。受伤类别之间以及按心理健康（MH）症状分层的受伤类别之间的 HRQOL 模式尚未得到检验。在部署受伤的 SM 和退伍军人（n=4353）中，我们检查了特定受伤类别内 PTSD 和/或抑郁的 HRQOL 和筛查数据。
参与者包括参加 Wounded Warrior Recovery Project 的人员，他们在 2017 年 6 月至 2020 年 5 月期间有完整的 HRQOL（SF-36）数据。使用 Barell 损伤诊断矩阵（Barell Matrix）对损伤进行分类。为每个损伤类别计算平均生理成分综合评分（PCS）和心理成分综合评分（MCS），并按 PTSD 和/或抑郁的可能性进行分层。
参与者在受伤后接受调查的平均随访时间为 10.7 年。大多数参与者为男性，非西班牙裔白人，曾在陆军服役，军衔为 enlisted rank。77%的损伤机制与爆炸物有关。整个样本的平均 PCS 和 MCS 评分分别为 43.6（SD=10.3）和 39.5（SD=13.3）；50%的人筛查出抑郁和/或 PTSD 阳性。在每个损伤类别中，有 PTSD 和/或抑郁可能性的个体的 PCS 和 MCS 评分明显低于没有可能性的个体。
在部署受伤的 SM 中，有 PTSD 和/或抑郁可能性的个体报告说，在受伤类别内和 HRQOL 组成部分（即身体或心理）中，他们的 HRQOL 明显较低。这些发现与先前的报告一致，即心理健康症状与较低的 HRQOL 密切相关，并表明将心理健康治疗纳入标准护理实践以改善长期 HRQOL。
