Resilience and Health-Related Quality of Life Following Discharge From a Level 1 Trauma Center

Abstract

Trauma can notably impact health-related quality of life (HRQoL) and result in psychiatric symptomology. There is a dearth of longitudinal research examining resilience as a predictor of HRQoL and depression outcomes post-exposure to trauma. This study examines the ability of resilience, as measured by the Connor-Davidson Resilience Scale 10-item (CD-RISC 10), to longitudinally predict mental and physical HRQoL and depression from a Level 1 trauma center at four timepoints: during hospitalization and at three, six, and 12 months post-discharge. Structural equation modeling was used to assess two models of resilience – one conceptualizing it as a latent variable using the CD-RISC 10 items, and the other using the CD-RISC 10 total score – to predict HRQoL and depression overtime. Both models accounted for potential associations with age and gender. Fit indices indicate that both models evidenced good fit to the data. The models had similar path estimates. Higher resilience was significantly associated with higher mental and physical HRQoL and lower depression at baseline and lower physical HRQoL at three months. Resilience was not significantly associated with HRQoL and depression at other measurement occasions. Age was significantly associated with lower physical HRQoL at baseline and lower depression at six months. Age was not significantly associated with other HRQoL or depression at other measurement occasions. Gender was not significantly associated with HRQoL or depression at any measurement occasion. Depression was consistently associated with subsequent assessments of depression. Depression was associated with lower mental and physical HRQoL over time, except for physical HRQoL at 12 months. Higher physical HRQoL was significantly associated with higher physical HRQoL at later assessments, and with lower depression at 12 months. Higher mental HRQoL was significantly associated with higher mental HRQoL at later assessments, and with lower depression and physical HRQoL at 12 months. However, baseline mental HRQoL at baseline was not able to predict mental HRQoL at 12 months. Baseline mental HRQoL was significantly associated with lower depression and physical HRQoL at 12 months.