Posttraumatic stress symptoms and health-related quality of life: a two year follow up study of injury treated at the emergency department

Background: Among injury victims relatively high prevalence rates of posttraumatic stress disorder (PTSD) have been found. PTSD is associated with functional impairments and decreased health-related quality of life (HRQoL). Previous studies that addressed the latter were restricted to injuries at the higher end of the severity spectrum. This study examined the association between PTSD symptoms and health-related quality of life (HRQoL) in a comprehensive population of injury patients of all severity levels and external causes.Methods: We conducted a self-assessment survey which included items regarding demographics of the patient, accident type, sustained injuries, EuroQol health classification system (EQ-5D) and Health Utilities Index (HUI) to measure functional outcome and HRQoL, and the Impact of Event Scale (IES) to measure PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of PTSD. The survey was completed by 1,781 injury patients two years after they were treated at the Emergency Department (ED), followed by either hospital admission or direct discharge to t

Examining factors that contribute to the process of resilience following spinal cord injury

STUDY DESIGN: Cross-sectional survey. OBJECTIVE: To examine factors that contribute to the process of positive adjustment, or resilience, in an adult community sample with spinal cord injury (SCI). SETTING: South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, South Australia, Australia. METHODS:A postal survey comprising standardised measures of resilience (Connor-Davidson Resilience Scale-10 item), self-efficacy (Moorong Self-Efficacy Scale), locus of control (Locus of Control of Behaviour Scale) and psychological distress (Depression Anxiety Stress Scale-21 item). RESULTS: Of 60 respondents, 58% reported moderate to high levels of resilience. Resilience correlated significantly with high self-efficacy (r=0.68, P0.05), time since injury (r=-0.14, P>0.05), gender (t(58)=-0.92, P>0.05), lesion completeness (t(57)=-0.86, P>0.05), or SCI diagnosis (t(58)=-1.21, P>0.05). A multiple regression indicated that psychological distress and self-efficacy were the only two variables that uniquely contributed to resilient behaviour. CONCLUSION: Resilience is an important psychological process in the longer-term management of SCI which can be promoted by targeting rehabilitation interventions towards mood management in addition to self efficacy beliefs. Larger-scale research will help to validate these results.SA Kilic, DS Dorstyn and NG Guive