Anke A G, Stanghelle J K, Finset A, Roaldsen K S, Pillgram-Larsen J, Fugl-Meyer A R
Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
J Trauma. 1997 Jan;42(1):54-61. doi: 10.1097/00005373-199701000-00010.
The prevalence of impairments and disabilities in activities of daily living (ADL), nonwork activities, and work were registered in a consecutive series (n = 69) of subjects with severe injuries. At follow-up 3 years after trauma, residual impairments prevailed in 80%. Only a few (6%) were ADL-dependent. Seventy-six percent had lost at least one nonwork activity, while vocational disability caused by the trauma occurred in 19%. Cognitive impairment was significantly associated with vocational disability, while physical impairment and pain were significantly associated with nonwork disability. Other parameters that influenced vocational disability negatively were age and blue-collar employment status. Although overall changes in social network quantity and quality were small, significantly more subjects with cognitive impairment or vocational disability experienced a decline in the quality and quantity of their social network after trauma. Furthermore, 25% of the subjects reported an increase in feelings of loneliness after trauma. We recommend the design of individualized, multidisciplinary rehabilitation plans before discharge from departments of surgery.
对连续纳入的69例重伤患者,记录其在日常生活活动(ADL)、非工作活动和工作方面的损伤及残疾发生率。创伤后3年随访时,80%的患者仍存在残留损伤。只有少数(6%)患者依赖ADL。76%的患者至少失去了一项非工作活动,而创伤导致的职业残疾发生率为19%。认知障碍与职业残疾显著相关,而身体损伤和疼痛与非工作残疾显著相关。对职业残疾产生负面影响的其他因素是年龄和蓝领就业状况。尽管社交网络的数量和质量总体变化较小,但创伤后,认知障碍或职业残疾患者的社交网络质量和数量明显下降。此外,25%的患者报告创伤后孤独感增加。我们建议在外科科室出院前制定个性化的多学科康复计划。