Limits...
Nurse-led psychological intervention after physical traumas: a randomized controlled trial.

Skogstad L, Hem E, Sandvik L, Ekeberg O - J Clin Med Res (2015)

Bottom Line: The aims were to study the effects of the psychological intervention relative to usual care (UC).Patients who talked with nurses with more training in psychological processing had a larger reduction in IES symptoms at 3 months (β = -0.3, P = 0.081).The nurse-led intervention had a significant effect on optimism and overall daily functioning.

View Article: PubMed Central - PubMed

Affiliation: Department of Research and Development, Division of Critical Care, Oslo University Hospital, Ulleval, Oslo, Norway ; Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

ABSTRACT

Background: Emergency room nurses were trained to provide a short-term psychological intervention in physically injured patients with Impact of Event Scale (IES) scores > 20. The aims were to study the effects of the psychological intervention relative to usual care (UC).

Methods: In a randomized controlled trial, psychological distress, daily functioning and the personality traits optimism/pessimism were compared with patients who received the UC. The interventions were provided 1 - 3 months after discharge.

Results: The IES scores were significantly reduced in both groups at 3 months (intervention: 41.1 - 28.6, P < 0.001 vs. UC: 35.4 - 26.2, P < 0.001), but not significantly different between groups. Baseline IES score was a significant predictor of IES scores at 3 (β = 0.4, P < 0.05) and 12 months (β = 0.3, P < 0.05), whereas overall daily functioning at 3 months predicted IES scores at 12 months (β = -0.5, P < 0.001). Patients receiving intervention became significantly more optimistic during the year, and had an increase in overall daily functioning from 3 to 12 months (P < 0.001). Patients declining intervention were more pessimistic and had lower daily functioning. Patients who talked with nurses with more training in psychological processing had a larger reduction in IES symptoms at 3 months (β = -0.3, P = 0.081).

Conclusion: The nurse-led intervention had a significant effect on optimism and overall daily functioning. Nurses may become a low-cost option to perform short-term psychological interventions with physically injured hospitalized patients.

No MeSH data available.


Related in: MedlinePlus

Flowchart for the nurse-led intervention vs. usual care.
© Copyright Policy - open access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4356095&req=5

Figure 1: Flowchart for the nurse-led intervention vs. usual care.

Mentions: This study was performed at Oslo University Hospital, Ulleval, Norway, a trauma referral center. Conscious adult patients (Glasgow coma scale (GCS) ≥ 11), 18 - 65 years old, with acute physical injuries (road traffic accidents, fall, violence and other injuries) were consecutively enrolled. A trauma-team was activated when the patient arrived at the hospital, and all patients were admitted for at least 6 h, some for days or weeks. A power analysis estimated a total of 160 patients, 80 in each group. At baseline, 323 conscious patients (GCS 14 - 15) responded (Fig. 1), of these 145 patients had an impact of event scale (IES) score ≥ 20 and were eligible for intervention. Patients were excluded if they had a stress score below clinical level (IES < 20, n = 158), lived more than 60 km from the hospital (too far for participating in the intervention), were incarcerated, unable to speak or read Norwegian, or had an unknown address, self-inflicted injuries, or serious psychiatric and/or substance abuse problems.


Nurse-led psychological intervention after physical traumas: a randomized controlled trial.

Skogstad L, Hem E, Sandvik L, Ekeberg O - J Clin Med Res (2015)

Flowchart for the nurse-led intervention vs. usual care.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356095&req=5

Figure 1: Flowchart for the nurse-led intervention vs. usual care.
Mentions: This study was performed at Oslo University Hospital, Ulleval, Norway, a trauma referral center. Conscious adult patients (Glasgow coma scale (GCS) ≥ 11), 18 - 65 years old, with acute physical injuries (road traffic accidents, fall, violence and other injuries) were consecutively enrolled. A trauma-team was activated when the patient arrived at the hospital, and all patients were admitted for at least 6 h, some for days or weeks. A power analysis estimated a total of 160 patients, 80 in each group. At baseline, 323 conscious patients (GCS 14 - 15) responded (Fig. 1), of these 145 patients had an impact of event scale (IES) score ≥ 20 and were eligible for intervention. Patients were excluded if they had a stress score below clinical level (IES < 20, n = 158), lived more than 60 km from the hospital (too far for participating in the intervention), were incarcerated, unable to speak or read Norwegian, or had an unknown address, self-inflicted injuries, or serious psychiatric and/or substance abuse problems.

Bottom Line: The aims were to study the effects of the psychological intervention relative to usual care (UC).Patients who talked with nurses with more training in psychological processing had a larger reduction in IES symptoms at 3 months (β = -0.3, P = 0.081).The nurse-led intervention had a significant effect on optimism and overall daily functioning.

View Article: PubMed Central - PubMed

Affiliation: Department of Research and Development, Division of Critical Care, Oslo University Hospital, Ulleval, Oslo, Norway ; Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.

ABSTRACT

Background: Emergency room nurses were trained to provide a short-term psychological intervention in physically injured patients with Impact of Event Scale (IES) scores > 20. The aims were to study the effects of the psychological intervention relative to usual care (UC).

Methods: In a randomized controlled trial, psychological distress, daily functioning and the personality traits optimism/pessimism were compared with patients who received the UC. The interventions were provided 1 - 3 months after discharge.

Results: The IES scores were significantly reduced in both groups at 3 months (intervention: 41.1 - 28.6, P < 0.001 vs. UC: 35.4 - 26.2, P < 0.001), but not significantly different between groups. Baseline IES score was a significant predictor of IES scores at 3 (β = 0.4, P < 0.05) and 12 months (β = 0.3, P < 0.05), whereas overall daily functioning at 3 months predicted IES scores at 12 months (β = -0.5, P < 0.001). Patients receiving intervention became significantly more optimistic during the year, and had an increase in overall daily functioning from 3 to 12 months (P < 0.001). Patients declining intervention were more pessimistic and had lower daily functioning. Patients who talked with nurses with more training in psychological processing had a larger reduction in IES symptoms at 3 months (β = -0.3, P = 0.081).

Conclusion: The nurse-led intervention had a significant effect on optimism and overall daily functioning. Nurses may become a low-cost option to perform short-term psychological interventions with physically injured hospitalized patients.

No MeSH data available.


Related in: MedlinePlus