Biopsychosocial factors associated with poor health-related quality of life after minor to moderate transport-related injuries: Insights into the Victorian compensable population
Stella Samoborec, Pamela Simpson, Rasa Ruseckaite, Darshini Ayton, Susan M. Evans
Department of Epidemiology and Preventive Medicine, Monash University, 3004 Melbourne, Australia. E-mail: firstname.lastname@example.org
Objective: To investigate whether a range of previously identified biopsychosocial risk factors were associated with poorer health-related quality of life after transport-related injuries.
Methods: This study involved 1,574 participants who sustained a transport-related injury, claimed compensation through the Victorian compensation scheme (in the Australian state of Victoria), and contributed to their cross-sectional outcome survey. Health-related quality of life was assessed using the EQ-5D-3L instrument.
Results: Of the 1,574 participants (mean age 44.8 (standard deviation 16.6) years, 61% reported poor recovery expectations, 55% reported high pain intensity, 54% reported poor satisfaction with care provided, and 41% reported no improvement in their recovery. Poor quality of life was defined as EQ-5D-3L summary score 0–0.70. Predictors of self-reported poor health-related quality of life included older age (65+ years) patients (adjusted odds ratios (aOR) = 1.73, 95% confidence interval (95% CI) 1.04–2.87), higher pain intensity (aOR = 2.17, 95% CI 1.27–3.71), self-reported pre-injury chronic pain (aOR = 1.47, 95% CI 1.00–2.17), self-reported pre-injury mental health issues (aOR = 2.62, 95% CI 1.80–3.82), no improvement in recovery in the last 3 months (aOR = 1.54, 95% CI 1.15–2.06), longer hospital stay (>7 days) (aOR = 2.34, 95% CI 1.43–4.21) and no support from the family (aOR = 2.37, 95% CI 1.62–3.46).
Conclusion: Biopsychosocial risk factors were associated with poorer health-related quality of life, regardless of the time since injury. Early assessment of these risk factors and tailored interventions will go some way towards improving outcomes among compensable patients with minor to moderate transport-related injuries.
Key words: recovery; health outcomes; road trauma; non-catastrophic injuries; compensation.
Transport-related injuries are a leading cause of disability and mortality. The literature indicates that while some of these injuries are severe and catastrophic, most are classified as minor and moderate. In practice, it is expected that patients with minor and moderate injuries will recover with no serious consequences. How-ever, recent research shows that, while half of patients recover relatively quickly, the other half experience long-term physical and mental health disabilities. The current study found multiple biopsychosocial factors impacting patients’ outcomes. The use of the biopsychosocial conceptual framework, previous systematic review and qualitative study enabled assessment of specific biopsychosocial factors impacting recovery in patients claiming compensation for minor and moderate transport-related injuries. The identification of specific biopsychosocial factors identified as affecting recovery in this cohort will enable the development of a screening instrument to identify those of highest risk of poor recovery and to further develop strategies to facilitate enhanced outcomes.
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