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Perceived social support is strongly associated with recovery after injury
Claudia P Orlas1, Juan P Herrera-Escobar, Ka Man Hau
1From the Center for Surgery and Public Health (C.P.O., J.P.H.-E., K.M.H.), Division of Trauma, Burn, and Surgical Critical Care (J.P.H.-E., N.P., A.S.), Brigham and Women's Hospital, Harvard Medical School; Division of Trauma, Emergency Surgery, and Surgical Critical Care (A.V., H.M.K.), Massachusetts General Hospital, Harvard Medical School; Division of Trauma, Acute Care Surgery & Surgical Critical Care (S.S.), Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; and Division of Trauma, Burn & Critical Care Surgery (D.N.), Harborview Medical Center, University of Washington, Seattle, Washington.
Background:
The strength of one's social support network is a potentially modifiable factor that may have a significant impact on recovery after injury. We sought to assess the association between one's perceived social support (PSS) and physical and mental health outcomes 6 months to 12 months postinjury.
Methods:
Moderate to severely injured patients admitted to one of three Level I trauma centers were asked to complete a phone-based survey assessing physical and mental health outcomes in addition to return to work and chronic pain 6 months to 12 months postinjury. Patients were also asked to rate the strength of their PSS on a 5-point Likert scale. Multivariate linear and logistic regression models were built to determine the association between PSS and postdischarge outcome metrics.
Results:
Of 907 patients included in this study, 653 (72.0%) identified themselves as having very strong/strong, 182 (20.1%) as average, and 72 (7.9%) as weak/nonexistent PSS. Patients who reported a weak/nonexistent PSS were younger and were more likely to be male, Black, and to have a lower level of education than those who reported a very strong/strong PSS. After adjusting for potential confounders, patients with a weak/nonexistent PSS were more likely to have new functional limitations and chronic pain in addition to being less likely to be back at work/school and being more likely to screen positive for symptoms of posttraumatic stress disorder, depression and anxiety at 6 months to 12 months postinjury than those with a strong/very strong PSS.
Conclusion:
Lower PSS is strongly correlated with worse functional and mental health outcome metrics postdischarge. The strength of one's social support network should be considered when trying to identify patients who are at greatest risk for poor postdischarge outcomes after injury. Our data also lend support to creating a system wherein we strive to build a stronger support network for these high-risk individuals.
Level Of Evidence:
Prognostic/epidemiologic, level III.
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