Appraisal, coping, social support, and posttraumatic stress of trauma patients one week following accidental injury

Abstract

The purposes of the study are to test relationships among injury appraisals, coping, social support and outcomes of coping efficacy, mood states, and post-traumatic stress; and to test the interaction effects of coping and social support on the relationship of stress and outcomes in the traumatically injured individual one week following accidental injury. The conceptual model for the study is primary derived from the stress and coping theory which includes major components of stress appraisals, coping, social support, and outcomes. A sample of 152 hospitalized trauma patients a week following accidental injury were recruited from two trauma centers. The measures included the injury appraisal of perceived stressor, perceived stressfulness, perceived controllability, and perceived injury severity; the modified Ways of Coping Scale (WCS); the brief Social Support Questionnaire (SSQ); the brief Profile of Mood State (POMS); the Impact of Event Scale (IES); and selected demographic and injury related variables.;Data were analyzed by multivariate statistics. The results indicated that perceived controllability (beta=.17, p<.01), satisfaction with social support (beta=.27, p<.01), wishful thinking (beta=-.33, p<.01), and problem-focused coping (beta=.23, p<.01), were the significant predictors for coping efficacy; perceived stressfulness (beta=.33, p<.01), problem-focused coping (beta=-.19, p<.01), and wishful thinking (beta=.47, p<.01),explained a significant amount of variance in mood states; and avoidance coping (beta=.42, p<.01), and wishful thinking (beta=.23, p<.01), were the significant predictors for post-traumatic stress. The moderating effects of emotion-focused coping at high and medium levels were identified as the underlying mechanism that affects coping efficacy by enhancing negative effect of stress on outcome. No buffering effects of social support were identified in the study. These findings can be used to identify traumatically injured patients who are at risk for mood disturbance and post-traumatic stress in the trauma center. Nursing interventions to address these factors can be developed and tested. Longitudinal studies are needed for understanding the mechanism of relationships among appraisals, coping, social support and outcomes of coping efficacy, mood states, and post-traumatic stress.