Post Traumatic Stress and Related Factors in Some Hand Replantation Patients

San-Hui Lee; Mi Ah Han; Jong Park; So Yeon Ryu

doi:10.15384/kjhp.2016.16.1.67

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Lee, Han, Park, and Ryu: Post Traumatic Stress and Related Factors in Some Hand Replantation Patients

Original Article

Korean J Health Promot 2016;16(1):67-75.

Published online: 20 January 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.1.67

Post Traumatic Stress and Related Factors in Some Hand Replantation Patients

San-Hui Lee^1,², Mi Ah Han^3,, Jong Park³, So Yeon Ryu³

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 31 August 2015 Accepted 6 November 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Amputation, Hand injuries, Risk factors, Stress disorders, post-traumatic

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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 finger^a	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%.

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