J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 7, Number 5, May 2015, pages 339-347

Nurse-Led Psychological Intervention After Physical Traumas: A Randomized Controlled Trial

**Table 1.** Background Variables for Physically Injured Patients in a Randomized Psychological Intervention Study
Variables	Nurse-led intervention (n = 35)	Usual care (n = 50)	P value intervention vs. usual care	Declined consultation (n = 17)
Note: Patients with registrations at 3 months.
Age (years), mean (95% CI)	41.7 (37.2 - 46.3)	36.9 (33.0 - 40.7)	< 0.05*	41.8 (34.2 - 49.4)
Gender, male n (%)	10 (28.6)	25 (50.0)	< 0.05*	9 (52.9)
Level of education, n (%)			ns
Primary and secondary school	13 (38.2)	30 (60.0)		8 (50.0)
College/university	21 (61.8)	20 (40.0)		8 (50.0)
Living status, n (%)
Married/cohabitant - yes	19 (54.3)	24 (48.0)	ns	13 (76.5)
Custody of children - yes	15 (42.9)	20 (40.0)	ns	7 (43.8)
Working status, n (%)			ns
Working/studying - yes	28 (80.0)	42 (84.0)		12 (70.6)
Previous psychiatric problems - yes	7 (20.6)	9 (18.4)	ns	3 (17.6)

Table 1. Background Variables for Physically Injured Patients in a Randomized Psychological Intervention Study

Variables

Nurse-led intervention (n = 35)

Usual care (n = 50)

P value intervention vs. usual care

Declined consultation (n = 17)

Note: Patients with registrations at 3 months.

Age (years), mean (95% CI)

41.7 (37.2 - 46.3)

36.9 (33.0 - 40.7)

< 0.05*

41.8 (34.2 - 49.4)

Gender, male n (%)

10 (28.6)

25 (50.0)

< 0.05*

9 (52.9)

Level of education, n (%)

Primary and secondary school

13 (38.2)

30 (60.0)

8 (50.0)

College/university

21 (61.8)

20 (40.0)

8 (50.0)

Living status, n (%)

Married/cohabitant - yes

19 (54.3)

24 (48.0)

13 (76.5)

Custody of children - yes

15 (42.9)

20 (40.0)

7 (43.8)

Working status, n (%)

Working/studying - yes

28 (80.0)

42 (84.0)

12 (70.6)

Previous psychiatric problems - yes

7 (20.6)

9 (18.4)

3 (17.6)

**Table 2.** Clinical Variables in Physically Injured Patients Measured During the Hospital Stay
Clinical variables	Nurse-led intervention (n = 35)	Usual care (n = 50)	P value intervention vs. usual care	Declined consultation (n = 17)
Type of injury, n (%)			ns
Fall/other accident	7 (20.6)	9 (18.0)		7 (41.2)
Transport accident	26 (76.5)	38 (76.0)		10 (58.8)
Violence	1 (2.9)	3 (6.0)		0 (0)
Injury severity scale (ISS), mean (95% CI)			ns
Minor/moderate (ISS score 1 - 8), n (%)	20 (58.8)	30 (62.5)		11 (64.7)
Serious (ISS score 9 - 15)	11 (32.4)	11 (22.9)		3 (17.6)
Severe (ISS score 16 - 24)	3 (8.8)	4 (8.3)		1 (5.9)
Critical (ISS score > 24)	0 (0)	3 (6.3)		2 (11.8)
Length of hospital stay, median (range)	2.0 (0 - 19)	2.0 (0 - 52)	ns	1.0 (0 - 14)
Discharged: other hospital/rehabilitation	6 (17.6)	15 (30.6)	ns	3 (18.8)

Table 2. Clinical Variables in Physically Injured Patients Measured During the Hospital Stay

Clinical variables

Nurse-led intervention (n = 35)

Usual care (n = 50)

P value intervention vs. usual care

Declined consultation (n = 17)

Type of injury, n (%)

Fall/other accident

7 (20.6)

9 (18.0)

7 (41.2)

Transport accident

26 (76.5)

38 (76.0)

10 (58.8)

Violence

1 (2.9)

3 (6.0)

0 (0)

Injury severity scale (ISS), mean (95% CI)

Minor/moderate (ISS score 1 - 8), n (%)

20 (58.8)

30 (62.5)

11 (64.7)

Serious (ISS score 9 - 15)

11 (32.4)

11 (22.9)

3 (17.6)

Severe (ISS score 16 - 24)

3 (8.8)

4 (8.3)

1 (5.9)

Critical (ISS score > 24)

0 (0)

3 (6.3)

2 (11.8)

Length of hospital stay, median (range)

2.0 (0 - 19)

2.0 (0 - 52)

1.0 (0 - 14)

Discharged: other hospital/rehabilitation

6 (17.6)

15 (30.6)

3 (18.8)

**Table 3.** Psychological Distress and Optimism/Pessimism Measured the First Year Following a Physical Injury
Mean (95% CI)	Nurse-led intervention (n = 35)	Usual care (n = 50)	P value intervention vs. usual care	Declined consultation (n = 17)
Note: Patients with registrations at 3 months. P < 0.05, *P < 0.001.
Posttraumatic symptoms (IES)
Baseline (1 month)	41.1 (36.9 - 45.4)	35.4 (32.2 - 38.6)	< 0.05*	38.4 (30.7 - 46.1)
3 months	28.6 (23.2 - 34.0)	26.2 (21.9 - 30.6)	ns	28.5 (20.1 - 36.9)
12 months	27.1 (20.7 - 33.4)	24.4 (18.0 - 30.9)	ns	25.3 (21.4 - 29.3)
P value within group: 1 - 3 months	< 0.001**	< 0.001**		< 0.05*
Anxiety (HADS-A)
Baseline (1 month)	9.4 (8.2 - 10.6)	8.4 (7.1 - 9.8)	ns	8.3 (5.6 - 11.1)
3 months	7.3 (5.8 - 8.9)	7.3 (5.9 - 8.8)	ns	7.2 (4.4 - 10.1)
12 months	6.2 (4.5 - 7.8)	7.1 (5.3 - 8.7)	ns	6.8 (3.9 - 9.6)
P value within group: 1 - 3 months	< 0.05*	< 0.05*		ns
Depression (HADS-D)
Baseline (1 month)	6.3 (5.0 - 7.6)	5.5 (4.3 - 8.7)	ns	6.1 (3.4 - 8.7)
3 months	4.6 (3.2 - 6.0)	4.8 (3.4 - 6.0)	ns	5.6 (3.3 - 7.8)
12 months	3.1 (1.8 - 4.4)	3.9 (2.3 - 5.5)	ns	3.7 (2.8 - 4.7)
P value within group: 1 - 3 months	< 0.05*	ns		ns
Optimism/pessimism (LOT-R)
Baseline (1 month)	15.6 (14.0 - 17.1)	14.9 (13.6 - 16.3)	ns	11.9 (9.7 - 14.0)
12 months	17.3 (15.4 - 19.2)	14.8 (12.7 - 16.9)	0.068	15.3 (11.8 - 18.8)
P value within group: 1 - 12 months	< 0.05*	ns		ns

Table 3. Psychological Distress and Optimism/Pessimism Measured the First Year Following a Physical Injury

Mean (95% CI)

Nurse-led intervention (n = 35)

Usual care (n = 50)

P value intervention vs. usual care

Declined consultation (n = 17)

Note: Patients with registrations at 3 months. *P < 0.05, **P < 0.001.

Posttraumatic symptoms (IES)

Baseline (1 month)

41.1 (36.9 - 45.4)

35.4 (32.2 - 38.6)

< 0.05*

38.4 (30.7 - 46.1)

3 months

28.6 (23.2 - 34.0)

26.2 (21.9 - 30.6)

28.5 (20.1 - 36.9)

12 months

27.1 (20.7 - 33.4)

24.4 (18.0 - 30.9)

25.3 (21.4 - 29.3)

P value within group: 1 - 3 months

< 0.001**

< 0.05*

Anxiety (HADS-A)

Baseline (1 month)

9.4 (8.2 - 10.6)

8.4 (7.1 - 9.8)

8.3 (5.6 - 11.1)

3 months

7.3 (5.8 - 8.9)

7.3 (5.9 - 8.8)

7.2 (4.4 - 10.1)

12 months

6.2 (4.5 - 7.8)

7.1 (5.3 - 8.7)

6.8 (3.9 - 9.6)

P value within group: 1 - 3 months

< 0.05*

Depression (HADS-D)

Baseline (1 month)

6.3 (5.0 - 7.6)

5.5 (4.3 - 8.7)

6.1 (3.4 - 8.7)

3 months

4.6 (3.2 - 6.0)

4.8 (3.4 - 6.0)

5.6 (3.3 - 7.8)

12 months

3.1 (1.8 - 4.4)

3.9 (2.3 - 5.5)

3.7 (2.8 - 4.7)

P value within group: 1 - 3 months

< 0.05*

Optimism/pessimism (LOT-R)

Baseline (1 month)

15.6 (14.0 - 17.1)

14.9 (13.6 - 16.3)

11.9 (9.7 - 14.0)

12 months

17.3 (15.4 - 19.2)

14.8 (12.7 - 16.9)

0.068

15.3 (11.8 - 18.8)

P value within group: 1 - 12 months

< 0.05*

**Table 4.** Predictors of Posttraumatic Stress in Physically Injured Patients 3 and 12 Months After Psychological Nurse-Led Intervention (Linear Regression Analyses)
	Unadjusted (enter) variables	Adjusted (multivariable) (backward) variables
Dependent variable: IES sum score at 3 and 12 months. ^aWith more relevant training for psychological processing. Note: Patients in the intervention and usual care groups. P < 0.05, *P < 0.001.
3 months
Age: continuous	0.3	-0.2-0.3	0.3	ns
Gender: 1 = man, 2 = woman	-0.1	-12.7 - -0.6	-1.9	ns
IES baseline (sum score)	0.4	0.3 - 0.8	4.6	< 0.001**	0.4	0.02 - 0.8	2.2	< 0.05*
LOT baseline (sum score)	-0.9	-1.6 - -0.3	-2.8	< 0.05*
Nurse-led intervention: yes/no	-0.8	-9.1-4.4	-0.7	ns
Psych trained nurses: 1 = no, 2 = yes^a	-0.2	-18.4-3.1	-1.4	ns	-0.3	-19.4-1.2	-1.8	0.081
12 months
Age: continuous	0.04	-0.3-0.4	0.3	ns
Gender: 1 = man, 2 = woman	-0.1	-11.4-7.2	-0.4	ns
IES baseline (sum score)	0.4	0.2 - 0.9	3.0	< 0.05*	0.3	0.1 - 0.8	2.9	< 0.05*
LOT baseline (sum score)	-1.2	-2.0 - -0.4	-2.9	< 0.05*
Nurse-led intervention: yes/no	-0.1	-11.5-6.2	-0.6	ns
Psych trained nurses: 1 = no, 2 = yes^a	-0.2	-21.9-4.3	-1.4	ns
Functioning at 3 months (sum score)	-0.5	-1.8-0.6	-4.1	< 0.001**	-0.5	-1.8-0.7	-4.4	< 0.001**

Table 4. Predictors of Posttraumatic Stress in Physically Injured Patients 3 and 12 Months After Psychological Nurse-Led Intervention (Linear Regression Analyses)

Unadjusted (enter) variables

Adjusted (multivariable) (backward) variables

95% CI

Sign.

95% CI

Sign.

Dependent variable: IES sum score at 3 and 12 months. ^aWith more relevant training for psychological processing. Note: Patients in the intervention and usual care groups. *P < 0.05, **P < 0.001.

3 months

Age: continuous

0.3

-0.2-0.3

0.3

Gender: 1 = man, 2 = woman

-0.1

-12.7 - -0.6

-1.9

IES baseline (sum score)

0.4

0.3 - 0.8

4.6

< 0.001**

0.4

0.02 - 0.8

2.2

< 0.05*

LOT baseline (sum score)

-0.9

-1.6 - -0.3

-2.8

< 0.05*

Nurse-led intervention: yes/no

-0.8

-9.1-4.4

-0.7

Psych trained nurses: 1 = no, 2 = yes^a

-0.2

-18.4-3.1

-1.4

-0.3

-19.4-1.2

-1.8

0.081

12 months

Age: continuous

0.04

-0.3-0.4

0.3

Gender: 1 = man, 2 = woman

-0.1

-11.4-7.2

-0.4

IES baseline (sum score)

0.4

0.2 - 0.9

3.0

< 0.05*

0.3

0.1 - 0.8

2.9

< 0.05*

LOT baseline (sum score)

-1.2

-2.0 - -0.4

-2.9

< 0.05*

Nurse-led intervention: yes/no

-0.1

-11.5-6.2

-0.6

Psych trained nurses: 1 = no, 2 = yes^a

-0.2

-21.9-4.3

-1.4

Functioning at 3 months (sum score)

-0.5

-1.8-0.6

-4.1

< 0.001**

-0.5

-1.8-0.7

-4.4

< 0.001**