When someone incurs a minor injury, such as a broken leg or fractured rib, providers may not look beyond that patient’s immediate injury. But new research from Therese Richmond and Sara Jacoby of the University of Pennsylvania shows that may not be the best approach. 

Dr. Richmond, the Andrea B. Laporte Professor of Nursing and associate dean for research and innovation at the Penn School of Nursing, and Dr. Jacoby, a postdoctoral fellow in the Penn Injury Science Center found that people who visited an emergency department for a minor injury and also expressed symptoms of anxiety and depression were more likely than other emergency department visitors to experience poor work performance and increased health-related time in bed after 12 months. The work is published in the International Journal of Nursing Studies.

“If an injury is not life-threatening, we tend to patch people up and send them home,” said Dr. Richmond.

Drs. Richmond and Jacoby wanted to determine the long-term outcomes for these patients. They used data collected from previous work about long-term recovery from minor injuries, which had included information about patients’ symptoms of depression and anxiety using symptom-severity scales.

In the previous study, published in 2009, the researchers used standard criteria to identify 1,110 patients who had sustained minor injuries, after excluding those with head trauma, those with a previous psychiatric diagnosis and those hospitalized during the past year for another minor injury. From this group, 275 men and women of varying races and ethnicities were randomly selected and interviewed at intake in the emergency room, as well as at three, six and 12 months post-injury.

Drs. Richmond and Jacoby learned that people with more symptoms of depression at the time of their injury still had trouble working a year later and more frequently required bed rest due to health problems.

“What our work over time shows, and this reinforces, is we can’t separate people into psych and physical because there’s an interplay that’s important to understand,” Dr. Richmond said. “My goal of care as a nurse is, ‘I want you to live your life to the best that you can, I want you to have optimal function, I want you to be able to go back to your normal activities.’ If we don’t incorporate the psychological wellness after injury, I’m not going to help people reach that goal.”