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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Intentions Matter: Long-Term Patient Outcomes After Intentional, Interpersonal Injury.

Colby Wilson¹, Joseph Kern¹, Kathleen O'Neill¹

¹Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

The Journal of Surgical Research

|December 19, 2025

Summary

This summary is machine-generated.

Trauma patients intentionally injured by interpersonal violence have higher rates of post-traumatic stress disorder (PTSD). Early screening and mental health support are crucial for survivors of intentional trauma.

Keywords:

Anxiety Depression Mental health Patient-reported outcomes Post traumatic stress disorder Trauma

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Area of Science:

Trauma Surgery
Psychiatry
Public Health

Background:

Traumatic injuries can cause long-term physical, mental, and social challenges.
Interpersonal violence as a cause of injury can exacerbate safety concerns and impede recovery.

Purpose of the Study:

To compare long-term patient-reported outcomes based on injury intent.
To investigate if mental health outcomes are worse in patients injured by interpersonal violence compared to unintentional injuries.

Main Methods:

Prospective data collection from adult trauma patients (n=315) from October 2019 to January 2024.
Assessment of post-traumatic stress disorder (PTSD) using PC-PTSD-5 and patient-reported outcomes via PROMIS-29.
Comparison of outcomes between unintentionally injured and intentionally injured (interpersonal violence) groups using descriptive statistics and multivariable logistic regression.

Main Results:

Intentionally injured patients (n=105) were younger, more severely injured, and more often female and Black compared to unintentionally injured patients.
Higher rates of positive PTSD screens were observed in intentionally injured patients (43.6%) versus unintentionally injured patients (22.6%) (P < 0.001).
Intentional injury was associated with a 2.1-fold increased odds of PTSD, while no significant association was found with anxiety or depression.

Conclusions:

Intentional injury significantly correlates with increased rates of PTSD following trauma.
Healthcare providers should prioritize mental health screening, particularly for PTSD, in survivors of interpersonal violence.
Tailored screening and treatment protocols are essential to address the specific mental health needs of trauma patients, especially those experiencing intentional harm.