ABSTRACT
PURPOSE: There is a high incidence of posttraumatic stress disorder (PTSD), depression, suicide risk, and psychological distress after orthopedic trauma and hand and upper-extremity injury. Although patients with traumatic adult brachial plexus injury are particularly vulnerable to psychologic distress, minimal clinical data exist about this cohort of patients. In this study, we sought to discover the prevalence of depression, PTSD, suicidal ideation, and substance abuse. METHODS: Between February, 2013 and July, 2014, during scheduled preoperative and/or postoperative appointments, the social worker at a metropolitan brachial plexus center conducted psychosocial assessments and questionnaire assessments of 21 patients evaluating for PTSD, depression, and substance use using 3 validated scales: PTSD Checklist-Specific, Patient Health Questionnaire-8, and National Institute on Drug Abuse Quick Screen. RESULTS: Brachial plexus injury strongly affected self-reported psychological well-being; 7 of 21 (33.3%) divulged suicidal ideation. Diagnosticand Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnosis was supported by PTSD Checklist-Specific and Patient Health Questionnaire-8 results: 4 of 21 (19.0%) met criteria for PTSD and 4 of 21 (19.0%) exhibited clinical depression. Patients reported no changes in social alcohol and tobacco use or substance abuse. CONCLUSIONS: Brachial plexus injury significantly influences psychological well-being and daily functioning. As a result, patients experience a high prevalence of PTSD, depression, and suicidal ideation. Patients with brachial plexus injury have a high prevalence of psychological concerns and challenges that require continued attention throughout treatment. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
Subject(s)
Brachial Plexus Neuropathies/psychology , Brachial Plexus/injuries , Depression/diagnosis , Stress Disorders, Post-Traumatic/diagnosis , Suicidal Ideation , Adult , Brachial Plexus Neuropathies/etiology , Depression/etiology , Female , Humans , Male , Retrospective Studies , Stress Disorders, Post-Traumatic/etiology , Surveys and QuestionnairesABSTRACT
BACKGROUND: Arthritis and other musculoskeletal diseases are the most prevalent health conditions in the USA, causing enormous financial and social burdens, especially in underserved communities. Targeted care and prevention programs are urgently needed. QUESTIONS/PURPOSES: Within an overall goal of revealing health disparities, the questionnaire explored (1) the use of and access to healthcare, (2) the factors affecting quality of life, and (3) the levels of provider-patient communication. METHODS: A New York City musculoskeletal hospital conducted a community health needs survey among its diverse ethnic/racial communities. A 39-item questionnaire was administered online, by mail, and in person (in English, Spanish, and Chinese). Answers were analyzed in terms of sociodemographics, to define health disparities within a total sample and two subsamples. RESULTS: In the total sample, respondents were 60% White, 16% Black, 14% Hispanic/Latino, and 11% Asian, mostly female, and aged 50 to 79. More than 17% of the total sample indicated they could not access a healthcare provider when needed. Poor nutrition and lack of physical activity were large areas of concern, as were falls and poor self-reported health status. Nearly all respondents said they took steps to communicate with their healthcare providers. Dramatic health disparities were found between Whites and non-Whites (e.g., non-Whites were most likely to rate their health poorly, consider their diet fair or poor, lack health insurance, and be unable to access a healthcare provider). CONCLUSION: The findings are being used to further refine, develop, and expand the hospital's community programs, especially for culturally diverse and underserved communities.
