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Post Traumatic Stress and Related Factors in Some Hand Replantation Patients

Post Traumatic Stress and Related Factors in Some Hand Replantation Patients

Article information

Korean J Health Promot. 2016;16(1):67-75
Publication date (electronic) : 2016 January 20
doi : https://doi.org/10.15384/kjhp.2016.16.1.67
1Department of Public Health, Graduate School of Chosun University, Gwangju, Korea
2Department of Nursing, Gwangju Daejung Hospital, Gwangju, Korea
3Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
Corresponding author: Mi Ah Han, MD, PhD Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea Tel: +82-62-230-6481, Fax: +82-62-225-8293 E-mail: mahan@chosun.ac.kr
Received 2015 August 31; Accepted 2015 November 06.

Abstract

Background

The risk for a hand injury was increased according to industrial structure and lifestyle change. This study investigated the post traumatic stress (PTS) and related factors in some hand replantation patients.

Methods

Total 150 hand replantation patients in one hospital were selected using convenience sampling methods. General characteristics of patients, characteristics of injured hand, self-esteem and PTS were collected using self-reported questionnaires. And clinical characteristics of injured hand were obtained from a review of medical records. Descriptive analysis, t-test, ANOVA and multiple regression analysis were performed to determine the associated factors with the score of PTS.

Results

Among 150 patients, 80% were male and 94% had a job. The mean score of PTS was 22.2±16.9. In simple analysis, PTS score were associated with smoking status, injury day of the week, pain score and self-esteem. Finally, the subjects who injured in weekdays had significantly higher PTS score compared to subjects who injured in weekend (β=0.185, P=0.021) and pain score was positively associated with PTS score (β =0.181, P=0.027) in multiple regression analysis.

Conclusions

Injury day of the week and pain score were associated with PTS score in some hand replantation patients. Considering these results will help to management and improve quality of life of hand replantation patients.

General characteristics of study subjects (N=150)

Characteristics of injured hand

Self-esteem and post-traumatic stress

Post-traumatic stress score according to general characteristics

Post-traumatic stress s core according to characteristics of injured hand

Correlation between pain, satisfaction, self esteem and PTS

Factors associated with post-traumatic stress score

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Article information Continued

Table 1.

General characteristics of study subjects (N=150)

Variable Categories N %
Age, y 20–44 57 38.0
  45–64 81 54.0
  ≥ 65 12 8.0
Gender Male 120 80.0
  Female 30 20.0
Marital status Married 122 81.3
  Unmarried 28 18.7
Education level ≤ Middle school 28 18.7
  High school 77 51.3
  ≥ College 45 30.0
Religion Yes 79 52.7
  No 71 47.3
Job Yes 141 94.0
  No 9 6.0
Hobby Yes 84 56.0
  No 66 44.0
Income, ten thousand won <200 34 22.7
  200–399 59 39.3
  ≥ 400 57 38.0
Smoking status Current 23 15.3
  Former 22 14.7
  Never 105 70.0
Drinking frequency None 29 19.3
  1/month 26 17.3
  2–4/month 29 19.3
  2–3/week 45 30.0
  ≥ 4/week 21 14.0
Self-rated health Good 82 54.6
  Fair 55 36.7
  Poor 13 8.7

Table 2.

Characteristics of injured hand

Variable Categories Value
Past experience of hand injury Yes 37 (24.7)
  No 113 (75.3)
Location of injured hand Left 71 (47.3)
  Right 79 (52.7)
Injury day of the week Weekdays 120 (80.0)
  Weekend 30 (20.0)
Injured time zone Night 18 (12.0)
  Morning 54 (36.0)
  Afternoon 78 (52.0)
Places of occurrence Work place 114 (76.0)
  House 26 (17.3)
  Others 10 (6.7)
Type of occurrence Industrial accidents 94 (62.7)
  Others 56 (37.3)
Cause of occurrence Machinery 122 (81.3)
  Others 28 (18.7)
Type of amputation Total 74 (49.3)
  Subtotal 76 (50.7)
The number of injured finger <3 134 (89.3)
  ≥ 4 16 (10.7)
Injured fingera Thumb 47 (31.3)
  Index 72 (48.0)
  3rd finger 68 (45.3)
  4th finger 55 (36.7)
  5th finger 31 (20.7)
Injured finger area Zone I 20 (13.3)
  Zone II 79 (52.6)
  Zone III 31 (20.7)
  Zone IV 20 (13.3)
Pain   33.2±33.20
Functional satisfaction   68.8±19.48
Shape satisfaction   60.7±20.63

Values are presented as n (%) or mean ± standard deviation.

a

Multiple response.

Table 3.

Self-esteem and post-traumatic stress

  Value
Self-esteem 38.49±4.62
Post-traumatic stress 22.2±16.9
PTSD  
Non PTSD (≤ 24) 99 (66.0)
PTSD (≥ 25) 51 (34.0)

Abbreviation: PTSD, post-traumatic stress disorder. Values are presented as mean ± standard deviation or n (%).

Table 4.

Post-traumatic stress score according to general characteristics

Variable  Categories  PTS t/F (P)
Age, y 20–44 21.10±17.90 0.564 (0.570)
  45–64 22.33±16.68  
  ≥ 65 26.83±15.02  
Gender Male 21.08±16.44 –1.658 (0.099)
  Female 26.08±18.60  
Marital status Married 23.09±17.10 1.315 (0.191)
  Unmarried 18.42±16.24  
Education level ≤ Middle school 20.53±17.38 0.202 (0.817)
  High school 22.92±17.39  
  ≥ College 22.08±16.33  
Religion Yes 22.22±16.11 0.001 (0.999)
  No 22.22±18.02  
Job Yes 22.63±17.31 2.023 (0.066)
  No 15.88± 8.99  
Hobby Yes 20.10±15.85 –1.735 (0.085)
  No 24.92±18.09  
Income, ten thousand won <200 25.29±16.00 2.116 (0.124)
  200–399 18.76±16.16  
  ≥ 400 23.98±18.02  
Smoking status Current 16.56±16.54 3.361 (0.037)
  Former 17.09±13.27  
  Never 24.54±17.37  
Drinking frequency None 24.06±16.11 0.944 (0.440)
  1/month 21.23±15.04  
  2–4/month 20.68±17.01  
  2–3/week 25.00±18.88  
  ≥ 4/month 17.09±16.11  
Self-rated health Good 20.92±16.09 2.001 (0.139)
  Fair 22.09±17.71  
  Poor 31.00±18.10  

Abbreviation: PTS, post-traumatic stress. Values are expressed as mean ± standard deviation.

Table 5.

Post-traumatic stress s core according to characteristics of injured hand

Variable  Categories  PTS t/F (P)
Past experience of hand injury Yes 22.67±15.54 0.185 (0.854)
  No 22.07±17.50  
Location of injured hand Left 22.61±18.37 0.268 (0.789)
  Right 21.87±15.75  
Injury day of the week Weekdays 24.09±17.61 3.474 (0.001) 
  Weekend 14.76±11.77  
Injured time zone Night 20.92±16.09 2.001 (0.139)
  Morning 22.09±17.71  
  Afternoon 31.00±18.10  
Places of occurrence Work place 23.32±17.32 1.190 (0.307)
  House 17.65±14.71  
  Others 21.06±18.19  
Type of occurrence Industrial accidents 22.88±17.62 0.612 (0.542)
  Others 21.12±15.95  
Cause of occurrence Machinery 21.27±17.38 0.764 (0.516)
  Others 26.39±14.72  
Type of amputation Total 21.83±17.52 –0.276 (0.783)
  Subtotal 22.60±16.56  
The number of injured finger ≤ 3 21.79±16.87 –0.893 (0.374)
  ≥ 4 25.81±18.08  
Injured finger      
Thumb No 21.16±17.01 –1.134 (0.259)
  Yes 24.55±16.88  
Index No 24.24±18.14 1.530 (0.128)
  Yes 20.04±15.46  
3rd finger No 23.30±17.68 0.853 (0.395)
  Yes 20.92±16.14  
4th finger No 21.09±16.92 –1.073 (0.285)
  Yes 24.18±17.07  
5th finger No 21.47±16.42 –1.068 (0.287)
  Yes 25.12±19.02  
Injured finger area Zone I 23.80±11.61 0.229 (0.876)
  Zone II 21.13±17.45  
  Zone III 23.25±18.26  
  Zone IV 23.35±18.45  

Abbreviation: PTS, post-traumatic stress. Values are expressed as mean ± standard deviation.

Table 6.

Correlation between pain, satisfaction, self esteem and PTS

  PTS
Pain 0.225 (0.006)
Functional satisfaction –0.001 (0.988)
Shape satisfaction –0.129 (0.115)
Self esteem –0.165 (0.043)

Abbreviation: PTS, post-traumatic stress. Values are expressed as correlation coefficients (P-value).

Table 7.

Factors associated with post-traumatic stress score

Characteristics ß SE P-value
Gender (/male)      
Female 0.123 1.500 0.136
Job (/no)      
Yes 0.087 1.090 0.278
Hobby (/yes)      
No 0.134 1.688 0.094
Smoking status (/current smoker)      
Ex-smoker 0.063 0.617 0.538
Nonsmoker 0.136 1.322 0.188
Injury day of the week (/weekend)      
Weekdays 0.185 2.338 0.021
Pain score 0.181 2.236 0.027
Self-esteem –0.114 –1.421 0.158

F=3.477 (P=0.001), R

2

=16.5%.