BACKGROUND: The Trauma Survivors Network (TSN), a program developed to help patients and families manage the psychosocial impact of their injuries, combines information access, self-management training, peer support, and online social networking. The purpose of this study was to evaluate the effectiveness of the TSN in improving patient reported outcomes among orthopedic trauma patients at a Level I trauma center. METHODS: We prospectively enrolled 251 patients with either severe lower-extremity injuries or polytrauma in two cohorts: one group (n = 125) before implementation of the TSN and one group (n = 126) after implementation. Participants were interviewed during their initial hospital stay and at 6 months. Outcomes evaluated at 6 months included depression, anxiety, self-efficacy, health status, and patient activation. RESULTS: Participation in the individual components of the TSN was low, ranging between 3% for the NextSteps self-management program and 27% for receipt of the Patient and Family Handbook. There were no statistically significant differences between treatment and control groups in self-efficacy, anxiety, health status, or activation. There were statistically significant differences in depression (24% of patients with probable depression in the TSN group vs. 40% in the control group, p = 0.02). However, the groups were not balanced with respect to sex, education, and baseline social support. After controlling for these differences, the TSN group still had 49% lower odds (95% confidence interval, 0% to 74%) of depression (p = 0.05). CONCLUSION: The TSN represents a potentially important step toward the development of comprehensive psychosocial support programs for trauma survivors. Despite improvements in one important outcome, a key finding of this evaluation is the low rate of use of program components. This finding highlights the need for greater understanding of use barriers and efforts to increase adoption. LEVEL OF EVIDENCE: Therapeutic study, level IV.
BACKGROUND: The Trauma Survivors Network (TSN), a program developed to help patients and families manage the psychosocial impact of their injuries, combines information access, self-management training, peer support, and online social networking. The purpose of this study was to evaluate the effectiveness of the TSN in improving patient reported outcomes among orthopedic traumapatients at a Level I trauma center. METHODS: We prospectively enrolled 251 patients with either severe lower-extremity injuries or polytrauma in two cohorts: one group (n = 125) before implementation of the TSN and one group (n = 126) after implementation. Participants were interviewed during their initial hospital stay and at 6 months. Outcomes evaluated at 6 months included depression, anxiety, self-efficacy, health status, and patient activation. RESULTS: Participation in the individual components of the TSN was low, ranging between 3% for the NextSteps self-management program and 27% for receipt of the Patient and Family Handbook. There were no statistically significant differences between treatment and control groups in self-efficacy, anxiety, health status, or activation. There were statistically significant differences in depression (24% of patients with probable depression in the TSN group vs. 40% in the control group, p = 0.02). However, the groups were not balanced with respect to sex, education, and baseline social support. After controlling for these differences, the TSN group still had 49% lower odds (95% confidence interval, 0% to 74%) of depression (p = 0.05). CONCLUSION: The TSN represents a potentially important step toward the development of comprehensive psychosocial support programs for trauma survivors. Despite improvements in one important outcome, a key finding of this evaluation is the low rate of use of program components. This finding highlights the need for greater understanding of use barriers and efforts to increase adoption. LEVEL OF EVIDENCE: Therapeutic study, level IV.
Authors: Patrick M Meyers; Ira L Leeds; Zachary O Enumah; Richard A Burkhart; Jin He; Elliott R Haut; Jonathan E Efron; Fabian M Johnston Journal: Surgery Date: 2019-05-31 Impact factor: 3.982
Authors: Ira L Leeds; Patrick M Meyers; Zachary O Enumah; Jin He; Richard A Burkhart; Elliott R Haut; Jonathan E Efron; Fabian M Johnston Journal: Ann Surg Oncol Date: 2019-01-07 Impact factor: 5.344
Authors: Brian Grieve; Gabriel D Shapiro; Lucy Wibbenmeyer; Amy Acton; Austin Lee; Molly Marino; Alan Jette; Jeffrey C Schneider; Lewis E Kazis; Colleen M Ryan Journal: Arch Phys Med Rehabil Date: 2017-10-31 Impact factor: 4.060
Authors: Laura Zdziarski-Horodyski; Terrie Vasilopoulos; MaryBeth Horodyski; Jennifer E Hagen; Kalia S Sadasivan; Sharareh Sharififar; Matthew Patrick; Robert Guenther; Heather K Vincent Journal: Clin Orthop Relat Res Date: 2020-04 Impact factor: 4.755
Authors: Suzanne H Wiertsema; Johanna M van Dongen; Edwin Geleijn; Maaike Schothorst; Frank W Bloemers; Vincent de Groot; Raymond W J G Ostelo Journal: BMC Health Serv Res Date: 2017-01-31 Impact factor: 2.655
Authors: Laura Zdziarski-Horodyski; MaryBeth Horodyski; Kalia K Sadasivan; Jennifer Hagen; Terrie Vasilopoulos; Matthew Patrick; Robert Guenther; Heather K Vincent Journal: Trials Date: 2018-01-11 Impact factor: 2.279