title: Determinants of quality of life and role-related disability after injury: impact of acute psychological responses.
abstract: BACKGROUND
  The factors that determine quality of life (QOL) and disability after traumatic injury are poorly understood. This study identified the unique contributions that characteristics about the injury/hospital admission and acute psychological adjustment make in determining 12-month role-related disability and QOL.
  
  
  METHODS
  Consecutive admissions (n = 363) to a Level I trauma service were assessed just before discharge and followed up at 12 months. Structural equational modeling was used to examine the relationships between the acute factors and 12-month outcomes.
  
  
  RESULTS
  Characteristics of the individual's injuries measured in the acute setting significantly predicted 12-month disability but only indirectly predicted 12-month QOL. An individual's acute psychological response directly predicted both the level of disability and QOL at 12 months.
  
  
  CONCLUSIONS
  Both characteristics about an individual's injury and acute psychological responses play important roles in determining later QOL and role-related disability outcomes. Trauma care systems must consider both physical and psychological injury to offer effective and comprehensive healthcare management.
authors.affiliation: Australian Centre for Posttraumatic Mental Health, National Trauma Research Institute, University of Melbourne, Melbourne, Australia. mod@unimelb.edu.au
authors.forename: Meaghan L
authors.initials: ML
authors.lastname: O'Donnell
authors.forename: Mark
authors.initials: M
authors.lastname: Creamer
authors.forename: Peter
authors.initials: P
authors.lastname: Elliott
authors.forename: Christopher
authors.initials: C
authors.lastname: Atkin
authors.forename: Thomas
authors.initials: T
authors.lastname: Kossmann
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000523:psychology; D003422:Critical Care; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011581:Psychological Tests; D011788:Quality of Life; D012380:Role; D012649:Self Concept; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000523:psychology*