Loss and depression after traumatic injury: the importance of case management in the recovery process.
PURPOSES OF STUDY: This study aims to (1) explore the types of resource loss commonly experienced by trauma patients as a result of their injuries, (2) examine the relationship between loss of resources and depressive symptoms after traumatic injury, (3) identify the types of coping behaviors used during trauma recovery, and (4) identify other factors influencing depression after injury.


METHODS
Primary settings comprise the case managers working with trauma patients in hospital, rehabilitation, outpatient, and home environments.


METHODS
This study used a cross-sectional design. A sample of 50 trauma patients who had sustained an unintentional injury in the prior 1-4 months completed a single interview during which participants completed measures of general health, loss of resources, coping, and depressive symptoms. Types of resource losses were also explored through open-ended questions.


RESULTS
Symptoms of depression were prevalent in the sample. Participants experienced multiple and varied loss of resources, especially in financial and personal realms. Loss of resources and depression scores were significantly related. Participants reported using a variety of coping strategies, most commonly accepting the reality of their circumstances and limitations.


CONCLUSIONS
The case manager can serve an important role in the recognition of depression in trauma patients and the implementation of appropriate interventions, including referral to mental health professional for further evaluation. Strategies to aid in the prevention of depression after injury include early identification of individuals who are more vulnerable to resource loss, assessment of current resource stores, and facilitating and coordinating access to essential resources to aid in trauma recovery.
Van Horn
Elizabeth R
ER
Adult Health Department, University of North Carolina at Greensboro, NC 27402, USA. e_vanhorn@uncg.edu