230
G. Månum et al.
Table III. Healthcare provision since discharge from somatic
hospital
The first 2 years,
n
At study inclusion,
n
General practitioner (GP)
24
Psychologist/psychiatrist
26
Physiotherapist
13
Specialized rehabilitation service 9 20
16
9
2
19 15
5
6
3 3
4
1
Adaptations professional life a
Home care b
Specialized pain treatment
Plastic surgeon
a
Studies/work.
Nurse and/or nursing assistant and/or personal assistant.
b
For 4 participants who did not benefit adequately
from ongoing psychological treatment, we either con-
tributed to strengthening the ongoing treatment, or
provided additional follow-up with another expert.
Eighteen participants were in need of rehabilitation.
Of these, 11 already received adequate help, and 7
were referred to multidisciplinary rehabilitation (n = 2)
or physiotherapy (n = 5). Examples of clinical recom-
mendations in these referrals included evaluation of
orthopaedic aids and goal-oriented training to increase
functional ability.
Healthcare provision and long-term treatment needs Life satisfaction
All participants had received healthcare follow-up
since being discharged from the hospital. As shown in
Table III, follow-up conducted by a GP or psychologist/
psychiatrist was the most common, both after hospital
discharge and at the time of study inclusion. While 9
participants were referred to specialized inpatient re-
habilitation in the early phase, only 2 received regular
rehabilitation services at the time of study inclusion.
Of the initial 6 participants receiving regular healthcare
provision from pain specialists, only 4 were receiving
specialized pain treatment at study inclusion.
Healthcare needs were identified for all but 4 partici-
pants (Table IV). Thus, the evaluation of clinical findings
with current care provision indicated somatic and/or
psychological health issues in most of the participants,
several of whom had more than 1 health condition.
The participants presented symptoms and/or clini-
cal findings that resulted in referral for a radiological
examination (e.g. bony prominences), or a visit to an
ear, nose and throat specialist (e.g. weak or hoarse
voice), plastic surgeon (reconstructive surgery for
scars), orthopedic surgeon (e.g. knee issues), pain
specialist or GP. Clinical recommendations to the GP
were, for example, related to vocational benefits (n = 2),
oral medication (n = 5) and management/follow-up of
hypertension (n = 2). Ten participants presenting with
complex pain condition were discussed with or reffered
to a pain specialist. Twenty-two participants reported their physical health
to be unsatisfactory, and 17 reported their psycholo-
gical health to be unsatisfactory (Table II). Of the 22
participants reporting unsatisfactory physical health,
15 also reported unsatisfactory psychological health.
Thus, 2 participants were unsatisfied only with their
psychological health while 7 reported unsatisfactory
physical health, but satisfactory psychological health.
Six participants reported both their physical and psy-
chological health to be satisfactory. Only 2 participants
reported satisfactory physical health and unsatisfactory
psychological health.
When comparing the 15 participants reporting both
their psychological and physical health to be unsatis-
factory with those reporting combinations of satisfac-
tory physical or psychological health, we found no
statistical significant differences in NISS scores, but
significantly worse SF-36 PF-, pain- and PTSD-RI
total scores in the group reporting unsatisfactory phy-
sical and psychological health (data not shown). The
same results were found when comparing participants
reporting their physical health as being unsatisfactory
(n = 22), with participants reporting their physical
health as being satisfactory (n = 8) (Table V). Signifi-
cant correlations were found between scores of phy-
sical or psychological health and SF-36 PF (r = 0.58,
p < 0.001 and r = 0.42, p = 0.021, respectively).
Ongoing healthcare needs were identified in all 15
participants reporting their psychological and physical
Table IV. Healthcare needs
Table V. Study participant’s satisfaction with physical health
Identified healthcare needs, n
Yes
No
Further referrals or contact from the project team, n
General practitioner
Radiology (X-rays)
Ear, nose and throat specialist
Orthopaedic surgeon
Plastic surgeon
Specialized pain treatment
Psychologist/psychiatrist
Physiotherapy or multidisciplinary rehabilitation service
www.medicaljournals.se/jrm
26
4
14
1
1
1
2
10
4
7
NISS
SF-36 PF
Pain (NRS)
PTSD-RI
a
Li-Sat physical ≤ 4
(n = 22) Li-Sat physical > 4
(n = 8)
p a
24.5
80
4
22 23.0
100
1
9
0.629
0.001
0.042
0.027
Mann–Whitney non-parametric 2-sample test.
Li-Sat physical; Life Satisfaction scale physical health, NISS; New Injury
Severity Score, SF-36 PF; Short Form Health Survey Physical Function scale.
Pain; 0–10 numeric rating scale (NRS) mean pain severity over the previous
week, PTSD-RI; Post-Traumatic Stress Disorder Reaction Index.