Problems experienced during the first year of an acute traumatic hand injury – a prospective study

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Abstract
Evidence-based nursing of patients with acute traumatic hand injuries treated at the hand-surgical clinic calls for knowledge about long-term implications. The aim of the study was to investigate consequences of an acute traumatic hand injury during the first year after the accident. Specifically, the objectives were to investigate changes in the experience of physical and psychological problems over time, frequencies of remaining problems and the impact of the injury on work situation and life situation 1 year after the accident. The study was prospective and followed the patients from the first weeks to 1 year after the accident. Ninety-one patients were assessed three times during the year. Each time the patients answered study-specific questions, the Impact of Event Scale and the Hospital Anxiety and Depression Scale. Problems experienced decreased during the first 3 months but tended to remain unchanged during the rest of the year. In the 1-year follow-up, the majority of the patients experienced slight or moderate functional limitations in the hand, one-third had symptoms of trauma-related distress and one out of seven had troublesome pain. Half of the patients who had returned to work reported a worse work situation and 16% were still on the sick list. One-third of all patients considered their whole life situation to be worse as a result of the injury. Patients with amputations more often experienced a worse life situation. Blue-collar workers reported functional limitations and a worse life situation more often than white-collar workers. Patients with acute traumatic hand injuries requiring surgical treatment may experience problems, such as functional limitations, trauma-related distress and troublesome pain, with long-term implications for their work situation and life situation. Caring for hand-injured patients should include, not only surgical treatment and other actions for restoring the function of the hand, but also preventive action and follow-up of trauma-related distress and pain.

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