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Quality of life after multiple trauma: the effect of early onset psychotherapy on quality of life in trauma patients

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Abstract

Background and aims

The aim of this study was to improve health-related quality of life (HRQOL) related to depression, anxiety, pain, physical functioning and social aspects for severely injured trauma survivors by early onset cognitive behavioural therapy applied on the surgical ward.

Materials and methods

The study was a randomised, controlled study. Of 298 primary screened patients 171 were eligible and randomised. Ninety-two patients adhered to follow-up investigations at 6 and 12 months. Main outcome measure was a sum score according to O’Brien calculated of five different questionnaires (BDI, SF-36, STAI, SCL 90R, F-SOZU-22).

Results

The sum score for overall HRQOL did not show significant group differences at follow-up. Effects on HRQOL sub-dimensions within groups have been found. In the dimension of depression therapy group showed significant improvement from the first measurement to discharge from hospital (p < 0.001), 6 MFU (p = 0.004) and to 12 MFU (p = 0.013). Measures of anxiety showed significant improvement for the therapy group at discharge from hospital (p = 0.001). In the control group there was only a significant reduction in depression and anxiety from surgical ward to discharge (p = 0.013/p = 0.031).

Conclusions

Early onset cognitive therapy is not effective in improving overall HRQOL of severely injured patients but shows promising effects on depression and anxiety up to 12 months after trauma.

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Acknowledgment

Prof. Lehmkuhl and Dr. Melchers, Clinic for Psychiatry and Psychotherapy of Children and Adolescents, University of Cologne, for advice in construction of the treatment modules and supervision of psychotherapists. Prof. Lehmacher and Bettina Buchheister, IMSIE, University of Cologne, for statistical support.

Thanks to all cooperating nurses and surgeons on the wards of the participating hospitals. Our sources of support are (1) the Federal Ministry of Education and Research (Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie, BMBF, Kennziffer: 01 KO 9517/9) from 01/07/1996; (2) the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG, Kennziffer NE 385/6-1 und 6-2) from 01/01/1999 until 31/12/2000; (3) the Medical Faculty, University of Cologne, Köln-Fortune Programme.

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Authors and Affiliations

  1. Institute for Research in Operative Medicine (IFOM), Faculty of Medicine, University of Witten/Herdecke, Ostmerheimer Str. 200, 51109, Cologne, Germany

    Nicola Pirente, Christine Blum, Silja Wortberg, Sevgi Bostanci, Eva Berger, Rolf Lefering & Edmund A. M. Neugebauer

  2. Department of Trauma and Orthopedic Surgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany

    Bertil Bouillon

  3. Department for Trauma, Hand and Reconstructive Surgery, University of Cologne, Cologne, Germany

    Klaus E. Rehm

Authors
  1. Nicola Pirente
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  2. Christine Blum
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  3. Silja Wortberg
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  4. Sevgi Bostanci
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  5. Eva Berger
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  6. Rolf Lefering
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  7. Bertil Bouillon
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  8. Klaus E. Rehm
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  9. Edmund A. M. Neugebauer
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Corresponding author

Correspondence to Edmund A. M. Neugebauer.

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Pirente, N., Blum, C., Wortberg, S. et al. Quality of life after multiple trauma: the effect of early onset psychotherapy on quality of life in trauma patients. Langenbecks Arch Surg 392, 739–745 (2007). https://doi.org/10.1007/s00423-007-0171-8

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  • DOI: https://doi.org/10.1007/s00423-007-0171-8

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