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Four Questions Nurses Can Ask to Predict PTSD 1 Year After a Motor Vehicle Crash
Arnaud Leroy1, Olivier Cottencin, Julien Labreuche
1Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1772), Lille, France (Drs Leroy, Cottencin, and Vaiva); CHU Lille, Hôpital Fontan, Service de Psychiatrie de l'adulte, Lille, France (Drs Leroy, Molenda, Warembourg, and Vaiva, Ms Demarty, and Mr Duhem); Centre National de Ressource et de Résilience, Lille, France (Drs Leroy, Molenda, and Vaiva and Mr Duhem); CHU Lille, Hôpital Fontan, Service d'addictologie, Lille, France (Dr Cottencin); CHU-Lille Biostatistics Department, Lille, France (Mr Labreuche); CUMP Océan Indien, Etablissement Public de Santé Mentale de la Réunion, La Réunion, France (Dr Mascarel); CHU Grenoble Department of Psychiatry, Grenoble, France (Ms De Pourtales and Dr Bougerol); Department of Consultation Liaison Psychiatry, European Georges Pompidou Hospital, Paris, France (Ms De Pourtales and Dr Lemogne); Paris Aide aux Victimes, Paris, France (Ms Paget); Université de Paris, INSERM U1266, Institute de Psychiatrie et Neuroscience de Paris, France (Dr Lemogne); Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, France (Dr Lemogne); Department of orthopaedic surgery and trauma, Avicenne Hospital, APHP, university Sorbonne-Paris Nord, France (Dr Gregory); CHU-Lille Trauma Unit, University of Lille, Lille, France (Dr Chantelot); and Univ Lille, Inserm, CHU Lille, CIC1403-Clinical Investigation Center, Lille, France (Mss Demarty and Meyer and Mr Duhem).
Background:
The role of nurses in screening for posttraumatic stress disorder is crucial in trauma units.
Objectives:
To create and evaluate an easy and brief tool for nurses to predict chronic posttraumatic stress disorder 1 year after a motor vehicle crash.
Methods:
We performed a 1-year follow-up multicenter study from 2007 to 2015, including 274 patients injured in a motor vehicle crash who were hospitalized in an orthopedic trauma unit. Nurses administered the DEPITAC questionnaire. Posttraumatic stress disorder was measured by the Post-Traumatic Stress Disorder Checklist of symptoms during the first year following the crash. A multivariable logistic regression model was implemented to select items significantly associated with posttraumatic stress disorder to improve the DEPITAC questionnaire. Predictive performance to predict posttraumatic stress disorder 1 year after the motor vehicle crash was examined for these different models.
Results:
Of 274 patients studied, a total of 75.9% completed the questionnaire at 1 year of follow-up. We found that only two questions and two simple elements of the patient's medical record (other injury or a person dying during the crash, perception of vital threat, number of children, and length of stay in trauma) predicted posttraumatic stress disorder 1 year after a motor vehicle crash.
Conclusions:
The brevity of this evaluation, simple scoring rules, and screening test performance suggest that this new screening tool can be easily administered in the acute care setting by nurses.
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