Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Well-Being, the Netherlands; Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, the Netherlands.
Netwerk Acute Zorg Brabant (NAZB), Tilburg, the Netherlands.
J Psychosom Res. 2024 Sep;184:111833. doi: 10.1016/j.jpsychores.2024.111833. Epub 2024 Jun 19.
Surviving physical trauma can have a large impact on one's daily life. Patients are at increased risk for poor physical health, psychological complaints, and problems in role functioning - which is often experienced simultaneously. The present study explores the interconnectedness of physical, psychological, and role functioning during the first two years post-injury, both cross-sectionally and longitudinally from a network perspective.
3785 trauma patients (M = 64.2 years, SD = 18.9 years, 50.5% female) completed questionnaires on physical, psychological, and role functioning across six measurement occasions during the first two years post-injury. The Injury Severity Score (ISS) was retrieved from the local trauma registry. Mixed graphical network models and cross-lagged network models were estimated to examine which items of recovery played a central role and were mostly related to other items in cross-sectional and longitudinal networks respectively.
The cross-sectional networks showed especially strong interconnections between impairments of physical and role functioning and also within post-traumatic stress symptoms. The longitudinal networks extended these results by showing that pain, impaired mobility, limitations in self-care, anxiety/depressive symptoms, and several post-traumatic stress symptoms were strong predictors for impairments in functioning at later stages of recovery.
Our findings showed that impairments in physical, psychological, and role functioning experienced by trauma patients are largely intertwined across the two years following injury. Monitoring physical impairments and psychological complaints early in recovery might help to more promptly provide the best fitting aftercare for trauma patients, which can improve recovery on the long-term.
身体创伤的幸存会对一个人的日常生活产生重大影响。患者面临着更高的身体健康不良、心理投诉和角色功能障碍的风险，这些问题通常同时存在。本研究从网络的角度探讨了受伤后前两年身体、心理和角色功能之间的相互联系，包括横断面和纵向研究。
3785 名创伤患者（M=64.2 岁，SD=18.9 岁，50.5%为女性）在受伤后前两年的六个测量时间点上完成了身体、心理和角色功能的问卷。损伤严重程度评分（ISS）从当地创伤登记处获取。混合图形网络模型和交叉滞后网络模型用于评估哪些恢复项目在横断面和纵向网络中分别起到核心作用，以及与其他项目的关系最密切。
横断面网络显示身体和角色功能障碍之间以及创伤后应激症状内存在特别强烈的相互联系。纵向网络通过显示疼痛、活动受限、自我护理受限、焦虑/抑郁症状以及几种创伤后应激症状是后期恢复中功能障碍的强预测因素，扩展了这些结果。
我们的研究结果表明，创伤患者在受伤后两年内经历的身体、心理和角色功能障碍在很大程度上相互交织。在康复早期监测身体损伤和心理投诉可能有助于更及时地为创伤患者提供最佳的康复护理，从而改善长期康复效果。
