Physical Function and Mental Health in Trauma Intensive Care Patients: A 2-Year Cohort Study

Abstract

Objectives: This study was designed to examine changes in function over time after injury and to identify factors associated with long-term recovery that may be amenable to change through intervention.

Design: Prospective cohort study.

Setting: Intensive care in a tertiary hospital in Queensland, Australia.

Patients: Adult (n = 123) admitted to intensive care for treatment of injury.

Interventions: Data were collected prior to hospital discharge and 1, 6, 12, and 24 months post injury. Data included demographics, preinjury health, injury characteristics, acute care factors, psychosocial measures, and health status. Linear mixed-effects models were used to identify factors associated with physical function and mental health over time.

Measurements and Main Results: Physical function and mental health improved over time; however, the averages remained below Australian norms at 24 months. Optimistic perception of illness and greater self-efficacy were potentially modifiable factors associated with improved mental health and physical function over time. Greater perceived social support, also potentially modifiable, was associated with improved mental health. Injury insurance and income were significant nonmodifiable factors for mental health, with mental health gains associated with higher income. Hospital length of stay and injury insurance were nonmodifiable factors linked with physical function.

Conclusions: Improvements in physical function and mental health are evident in the 24 months following injury, but most patients remain below Australian population norms. Factors that were associated with physical function and mental health outcomes over time that are potentially amenable to change include illness perception, self-efficacy, and perceived social support.