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Center for Injury Research and Policy

Trauma Survivors Network

The Trauma Survivors Network (TSN) is a partnership between the Injury Center and the American Trauma Society (ATS).  Its goal is to ease the burden of injury and its consequences for patients and their families through the exchange of reliable information, education, peer support and, most importantly, promotion of self-management programs. 

Extensive research on the recovery process and psychology of injury and disability strongly indicates that full implementation of the TSN can have a positive impact on post-trauma outcomes. The TSN provides the following assistance to trauma survivors:

Trauma survivors and families are integrally involved in shaping the vision of the program and defining specific products and services. Full implementation of the TSN is being evaluated by Center faculty at the Maryland Shock Trauma Center with funding from CDC.

ATS aims to implement the TSN in more than 1,000 trauma centers around the country. Once implemented, patients and families will be introduced to the TSN Program when they receive the Trauma Patient and Family Handbook and information regarding online resources and blogging capabilities. Providers will be trained in the benefits of TSN and how best to communicate these benefits to both patients and their families. TSN programs and services will be incorporated into discharge plans, and physicians will be trained to recommend (i.e., prescribe) the services during patient follow-ups.  

When fully implemented, the TSN will provide a nationwide support service to trauma survivors focused on mobilizing communities’ collective strengths to assist trauma survivors in rebuilding their lives.  For more information contact the Trauma Survivors Network at 800-556-7890 or admin@traumasurvivorsnetwork.org.

Online Self-Management Program for Trauma

Despite substantial improvements made over the last two decades in orthopedic trauma care, severe leg injuries often result in poor functional outcomes for otherwise young, healthy individuals. Center faculty research, the Lower Extremity Assessment Project (LEAP), found that for many individuals undergoing reconstruction or amputation following limb-threatening leg injuries, disability remains high at two years post-injury and rates of return to work were low.

The LEAP study further demonstrated that outcomes were more affected by the patient's economic, social and personal resources than by the initial treatment of the injury, specifically amputation versus reconstruction and level of amputation. In particular, it was found that patients who at baseline reported low self-efficacy, weak social support and high levels of depression, anxiety and pain were significantly more likely to have poor long-term outcomes.

These results strongly suggest that major improvements in functional outcome require interventions in the early post-acute phase of recovery to directly address patients’ psychosocial needs and assist survivors in self-managing the multi-factorial consequences of their injury. 

Self-management (SM) interventions based on cognitive behavioral theory are particularly effective in increasing self-efficacy, reducing secondary conditions such as pain, anxiety and depression, and improving overall function and quality of life. These programs have gained widespread application with chronic conditions in which pain and disability are common. They have not, however, been broadly applied to younger, acutely injured individuals.

With funding from the CDC and U.S. Department of Defense, Center faculty are developing and evaluating the efficacy of a computer-based self- management program, NextSteps, for reducing secondary conditions and improving function following major lower limb trauma. The intervention will build on widely accepted self-management programs for persons with arthritis, as well as components of a face-to-face self-management program recently developed by members of the research team for civilians with longstanding limb loss.

The content and delivery of these programs will be tailored to accommodate the needs of a young, acutely injured population. Interventions for those injured in military service will require additional modification and specialization. Specific needs not typically addressed in the existing programs include the management of acute anxiety and post-traumatic stress disorder (PTSD), finding and maintaining employment, and returning to active duty.

For more information, contact Ellen MacKenzie at emacken1@jhu.edu.

Trauma systems are designed to provide an organized and coordinated response to injury in a defined geographic area. When fully operational, they ensure a continuum of care involving public access to the system, out-of-hospital emergency medical services, timely triage and transport to an appropriate level of hospital care, definitive acute care, and transfer to rehabilitation services if warranted.  Although there has been a significant improvement in the availability of hospital trauma resources, there remain several challenges to ensure the optimal number, configuration and appropriate use of these resources.