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Background: The benefits of work for physical, psychological, and financial wellbeing are well documented. Return to work (RTW) after unintentional injury is often delayed, and psychological morbidity may contribute to this delay. The impact of psychological morbidity on RTW after a wide range of unintentional injuries in the UK has not been adequately quantified.Aim: To quantify the role of psychological factors, including anxiety, depression, and post-traumatic distress, on RTW following unintentional injuries.Design and Setting: A longitudinal multicentre prospective study was undertaken in Nottingham, Bristol, Leicester, and Guildford, UK.Method: Participants (n = 273) were 16-69-year-olds admitted to hospital following unintentional injury, who were in paid employment prior to injury. They were surveyed at baseline, then at 1, 2, 4, and 12 months following injury; demographic data were collected along with injury characteristics, psychological morbidity, and RTW status. Associations between demographic, injury and psychological factors, and RTW between 2 and 12 months after injury were quantified using random effects logistic regression.Results: The odds of RTW between 2 and 12 months after injury reduced as depression scores early in the recovery period (1 month after injury) increased (odds ratio [OR] 0.87, 95% confidence interval [CI] = 0.79 to 0.95) and as length of hospital stay increased (OR 0.91, 95% CI] = 0.86 to 0.96). For those experiencing threatening life events following injury (OR 0.27, 95% CI = 0.10 to 0.72) and with higher scores on the Crisis Support Scale (OR 0.93, 95% CI] = 0.88 to 0.99), the odds of RTW between 2 and 12 months after injury were lower. Multiple imputation analysis found similar results, but those relating to crisis support did not remain statistically significant.Conclusion: Primary care professionals can identify patients at risk of delayed RTW who may benefit from management of psychological morbidity and support to RTW. [ABSTRACT FROM AUTHOR]

Background: In the UK, studies suggest that the transition from hospital to home after an injury can be a difficult time and many patients report feeling inadequately prepared. Patients often use primary care services after hospital discharge. These consultations provide opportunities to consider problems that patients experience and to facilitate recovery. Little is known, however, about how patients and service providers view care after hospital discharge and the role played by primary care services, specifically GPs. Aim: To identify good practice and unmet needs in respect of post-discharge support for injured patients. Design and Setting: Qualitative study using semi-structured interviews at four sites (Bristol, Leicester/Loughborough, Nottingham, and Surrey). Method: Qualitative interviews with 40 service providers and 45 hospitalised injured patients. Results: Although there were examples of well-managed hospital discharges, many patients felt they were not provided with the information they needed about their injury, what to expect in terms of recovery, pain control, return to work, psychological problems, and services to help meet their needs. They also described difficulty accessing services such as physiotherapy or counselling. Service providers identified problems with communication between secondary and primary care, lack of access to physiotherapy, poor communication about other services that may help patients, GP service and resource constraints, and difficulties in providing information to patients concerning likely prognosis. Conclusion: Discharge from hospital after an injury can be problematic for patients. Changes in both secondary and primary care are required to resolve this problem. [ABSTRACT FROM AUTHOR]

Objective: This study represents the first stage of a project to identify serious injury, at the level of Maximum Abbreviated Injury Scale (MAIS) 3 + (excluding fatal collisions) from within the police collision data. The resulting data will then be used to identify the vehicle drivers concerned and in later studies these will be culpability scored and profiled to allow targeting of interventions.Method: UK police collision data known as STATS19 for the county of Cambridgeshire were linked using Stata with Trauma Audit and Research Network (TARN) hospital trauma patient data for the same geographical area for the period April 2012 to March 2017. Linking was 2-stage: A deterministic process followed by a probabilistic process.Results: The linked records represent an individual trauma patient from TARN data linked to an individual trauma casualty from STATS19 data. Full collision data for the incident resulting in the trauma casualty were extracted. The resulting subset of collisions has the MAIS 3+ injury criteria applied. From the 10,498 recorded collisions, the deterministic linking process was successful in linking 257 MAIS 3+ trauma patients to collision injury subjects from 232 separate collisions with the probabilistic process linking a further 22 MAIS 3+ subjects from 21 collision events. The combined collision data for the 253 collisions involved 434 motor vehicle drivers.Conclusions: We produced viable results from the available data to identify MAIS 3+ collisions from the overall collision data. [ABSTRACT FROM AUTHOR]