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Health status of critically ill trauma patients

Authors

  • Leanne M Aitken RN, PhD, FRCNA,

    Professor of Critical Care Nursing, Corresponding author
    1. Research Centre for Clinical and Community Practice Innovation (RCCCPI), Griffith University & Princess Alexandra Hospital, Brisbane, Qld, Australia
    • Correspondence: Leanne M Aitken, Professor of Critical Care Nursing, School of Nursing and Midwifery, 170 Kessels Rd, Nathan, Griffith University, Brisbane, Qld 4111, Australia. Telephone: +61 7 3176 7256.

      E-mail: l.aitken@griffith.edu.au

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  • Wendy Chaboyer RN, PhD,

    Director
    1. NHMRC Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Research Centre for Clinical and Community Practice Innovation (RCCCPI), Griffith University, Gold Coast campus, Gold Coast, Qld, Australia
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  • Michael Schuetz FRACS, FAOrthA, Dr med,

    Dr med. Habil, Director of Trauma Service & Professor of Trauma
    1. Princess Alexandra Hospital and Queensland University of Technology, Brisbane, Qld, Australia
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  • Christopher Joyce ChB, MB, PhD, FANZCA,

    FCICM, Director of Intensive Care & Associate Professor
    1. Princess Alexandra Hospital, Brisbane, Qld, Australia
    2. School of Medicine, University of Queensland, Brisbane, Qld, Australia
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  • Bonnie Macfarlane BHSc, MPH

    Senior Research Officer/Statistical Epidemiologist
    1. Critical Care Nursing, Princess Alexandra Hospital & Griffith University, Brisbane, Qld, Australia
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Abstract

Aims and objectives

To describe the recovery of trauma intensive care patients up to six months posthospital discharge.

Background

Injury is a leading cause of preventable mortality and morbidity worldwide, with approximately 10% of hospitalised trauma patients being admitted to intensive care. Intensive care patients experience significant ongoing physical and psychological burden after discharge; however, the patterns of recovery and the subgroups of intensive care patients who experience the greatest burden are not described.

Design

This prospective cohort study was conducted in one tertiary referral hospital in south-east Queensland, Australia.

Methods

Following ethics approval, injured patients who required admission to intensive care provided consent. Participants completed questionnaires prior to hospital discharge (n = 123) and one (n = 93) and six months (n = 88) later. Data included demographic and socioeconomic details, pre-injury health, injury characteristics, acute care factors, postacute factors [self-efficacy, illness perception, perceived social support and psychological status as measured by the Kessler Psychological Distress Scale (K10) and the PTSD Civilian Checklist] and health status (SF-36).

Results

All participants required ongoing support from healthcare providers in the six months after discharge from hospital, and approximately half required support services such as accommodation and home modifications. Approximately 20% of participants reported post-traumatic stress symptoms, while approximately half the participants reported psychological distress. Average quality of life scores were significantly below the Australian norms both one and six months postdischarge.

Conclusions

Trauma intensive care patients rely on ongoing healthcare professional and social support services. Compromised health-related quality of life and psychological health persists at six months.

Relevance to clinical practice

Effective discharge planning and communication across the care continuum is essential to facilitate access to healthcare providers and other support services in the community setting.

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