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Title: Psychological morbidity and health related quality of life after injury: multicentre cohort study
Authors: Kendrick, Denise
Kellezi, Blerina
Coupland, Carol
Maula, A.
Beckett, Kate
Morriss, Richard
Joseph, Stephen
Barnes, Jo
Sleney, Jude
Christie, Nicola
Keywords: Unintentional injury
Quality of life
Cohort study
Issue Date: 2016
Publisher: © The Authors. Published by Springer Verlag (Germany)
Citation: KENDRICK, D. ... et al, 2016. Psychological morbidity and health related quality of life after injury: multicentre cohort study. Quality of Life Research, 26 (5), pp. 1233–1250.
Abstract: Purpose To demonstrate the impact of psychological morbidity 1 month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in the UK to inform development of trauma care and rehabilitation services. Methods Multicentre cohort study of 16–70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at recruitment and 1, 2, 4 and 12 months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity 1 month post-injury and MID in HRQoL over the 12 months after injury. Results A total of 668 adults participated. Follow-up rates were 77% (1 month) and 63% (12 months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1 month and 58% at 12 months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1 month post-injury were independently associated with subsequent MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship between anxiety and HRQoL was not explained by factors measured in our study. Conclusions Hospitalised injuries result in substantial reductions in HRQoL up to 12 months later. Depression and anxiety early in the recovery period are independently associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving HRQoL post-injury.
Description: This is an Open Access Article. It is published by Springer under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/
Sponsor: The project was funded by the National Institute for Health Research funding scheme for the Collaboration for Leadership in Applied Health Research and Care Nottinghamshire, Derbyshire and Lincolnshire, and now East Midlands.
Version: Published
DOI: 10.1007/s11136-016-1439-7
URI: https://dspace.lboro.ac.uk/2134/23047
Publisher Link: http://dx.doi.org/10.1007/s11136-016-1439-7
ISSN: 1573-2649
Appears in Collections:Published Articles (Design School)

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