oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Problems experienced during the first year of an acute traumatic hand injury: a prospective sudy
Örebro University, Department of Nursing and Caring Sciences.ORCID iD: 0000-0002-8658-3360
Örebro University, Department of Nursing and Caring Sciences. Centre for Nursing Research,Örebro University Hospital,Örebro, Sweden.
2004 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 8, p. 986-995Article in journal (Refereed) Published
Abstract [en]

Background. Evidence-based nursing of patients with acute traumatic hand injuries treated at the hand-surgical clinic calls for knowledge about long-term implications. Aims and objectives. The aim of the study was to investigate consequences of an acute traumatic hand injury during the first year after the accident. Specifically, the objectives were to investigate changes in the experience of physical and psychological problems over time, frequencies of remaining problems and the impact of the injury on work situation and life situation 1 year after the accident.

Design. The study was prospective and followed the patients from the first weeks to 1 year after the accident. Method. Ninety-one patients were assessed three times during the year. Each time the patients answered study-specific questions, the Impact of Event Scale and the Hospital Anxiety and Depression Scale.

Results. Problems experienced decreased during the first 3 months but tended to remain unchanged during the rest of the year. In the 1-year follow-up, the majority of the patients experienced slight or moderate functional limitations in the hand, onethird had symptoms of trauma-related distress and one out of seven had troublesome pain. Half of the patients who had returned to work reported a worse work situation and 16% were still on the sick list. One-third of all patients considered their whole life situation to be worse as a result of the injury. Patients with amputations more often experienced a worse life situation. Blue-collar workers reported functional limitations and a worse life situation more often than white-collar workers.

Conclusions. Patients with acute traumatic hand injuries requiring surgical treatment may experience problems, such as functional limitations, trauma-related distress and troublesome pain, with long-term implications for their work situation and life situation. Relevance to clinical practice. Caring for hand-injured patients should include, not only surgical treatment and other actions for restoring the function of the hand, but also preventive action and follow-up of trauma-related distress and pain.

Place, publisher, year, edition, pages
2004. Vol. 13, no 8, p. 986-995
Keywords [en]
disability, evidence-based nursing, hand injury, outcome, pain, psychological stress
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
URN: urn:nbn:se:oru:diva-3088DOI: 10.1111/j.1365-2702.2004.01019.xISI: 000224922100010PubMedID: 15533105Scopus ID: 2-s2.0-9244229494OAI: oai:DiVA.org:oru-3088DiVA, id: diva2:136861
Projects
Consequences of an acute traumatic hand injuryAvailable from: 2003-11-04 Created: 2003-11-04 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Konsekvenser av en akut traumatisk handskada: en prospektiv studie av patientens situation under det första året efter olyckan
Open this publication in new window or tab >>Konsekvenser av en akut traumatisk handskada: en prospektiv studie av patientens situation under det första året efter olyckan
2003 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the research project was to investigate the consequences of an acute traumatic hand injury during the first year after the accident. The project involved 112 patients with acute traumatic hand injuries requiring inpatient hand-surgical treatment. The majority of the patients were men. Most of them were injured at home or at their usual place of work. The hand injuries differed in degree of severity. Nearly one third of the patients had amputations.

The project comprised two qualitative and two quantitative studies. Data for the qualitative studies were obtained by interviews with a theoretical sample of 20 patients between 8 and 20 days after the accident. Data for the quantitative studies were obtained from a consecutive sample of patients by means of questionnaires answered 1-2 weeks, three months and one year after the accident. All 112 patients participated in the first and 91 patients in all three assessments. The questionnaires included were the Impact of Event Scale (IES) for measuring trauma-related distress, the Hospital Anxiety and Depression scale (HAD) for measuring mood disorders and study-specific questions for measuring problems experienced. Information about injuries and accidents was obtained from the patients’ medical records.

The results of the studies showed that psychological problems were frequent the first weeks after the injury and related to consequences of both the injury and the traumatic experience. Nearly half of the patients had symptoms of traumatic stress and one third had signs of a mood disorder. Negative reactions at the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observations of the patients’ reactions when the dressing is changed might help to identify those in need of psychological support in the early stage. One third still had increased levels of traumatic stress symptoms and one out of ten had signs of a mood disorder in the one-year follow-up.

The first weeks after the accident more than half of the patients reported substantially limited physical function and had a need for help with activities of vital importance in everyday life. Troublesome pain was felt by one third of the patients. Most patients experienced significant improvement during the first three months. One year after the accident the majority of the patients had slight or moderate physical limitations. Only one out of five experienced no limitations at all. One out of seven reported troublesome pain. Patients with amputations had more pain than others both the first weeks and one year after the accident.

About 16 % were on the sick-list one year after the accident. Half of the patients back at work experienced a worse work-situation as a result of the injury. One third of all patients experienced a worse life-situation. A worse life-situation was experienced not only by patients at the sick-list but also by patients back at work. Patients with amputations and blue-collar workers more often experienced a worse life-situation than others.

In sum, this project showed how important it is that the care of patients with acute traumatic hand injuries, in addition to surgical treatment and other action for restoring function in the hand, also should include preventive action and follow-up of trauma-related distress and pain.

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2003. p. 68
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 1
Keywords
Vårdvetenskap, Hand injuries, traumatic stress, anxiety, depression, pain, outcome, nursing, omvårdnadsforskning med medicinsk inriktning
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-48 (URN)91-7668-368-0 (ISBN)
Public defence
2003-11-28, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2003-11-04 Created: 2003-11-04 Last updated: 2017-10-18Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Gustafsson, MargaretaAhlström, Gerd

Search in DiVA

By author/editor
Gustafsson, MargaretaAhlström, Gerd
By organisation
Department of Nursing and Caring Sciences
In the same journal
Journal of Clinical Nursing
Nursing

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 586 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf