OROFACIAL TRAUMA VICTIMS--SUPPORT, COMPLIANCE, RECOVERY

University Of California Los Angeles, Los Angeles CA

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Abstract

This pilot study explores the relationships among social support, compliance and recovery over time for orofacial trauma victims. Patient compliance is considered a major problem in the treatment of orofacial fractures. Supportive social relationships are known to enhance patient compliance and offer physical and emotional benefits to victims of injury and illness. The success of support as a coping resource or situational mediator of stress depends on how well the support resource meets the recipients stress-related needs. To date, little is known about changes in support needs and support resources over the course of the recovery process. The specific research aims are: 1) to describe and predict the social support needs and support resources of orofacial trauma victims over the course of the recovery process; 2) to describe compliance over time and examine whether social support is predictive of compliance with medical care over the course of the recovery process; and 3) to examine whether social support is predictive of recovery from injury. Ultimately, the data obtained from this pilot study will be used to conduct preliminary modeling for a larger longitudinal study on the changing influence of social support on psychosocial adaptation, compliance and recovery from chronic illness or severe injury, and to inform the development of interventions that will address the support needs of patients, encourage compliance to treatment, promote recovery and reduce the risk of social isolation due to injury. This pilot project will be a three year longitudinal study of patients with orofacial trauma treated at the King-Drew Medical Center. Data will be obtained at three points in the recovery process (T1= prior to discharge from injury-related hospitalization; T2= 6 months following discharge; T3= 12 months following discharge). Patients will be selected during a two year enrollment period. Data will be obtained through structured interviews and surgeon examinations. Key measures will include perceived availability and adequacy of social support, health status/injury severity, indicators of patient compliance (percentage of appointments missed by patients per recall; failure to follow instructions about oral hygiene and medication), previous episodes of trauma. Sociodemographic data will also be obtained. Descriptive statistics will be used 1) to report patients' perceptions of the availability and adequacy of emotional, task and financial support at three points in the recovery process; and 2) to report sources of support who have been most helpful in providing emotional, task and financial support at T1, T2, and T3. Repeated measures ANOVA will be used 1) to examine the effects of time on compliance and on the number of sources of emotional, task and financial support during the recovery process (T1, T2, and T3). Repeated measures loglinear model will be used to assess changes in the perceived adequacy of emotional, task and financial support over time. Best subsets regression will be used to predict 1) the need for and adequacy of each type of social support; 2) medical compliance; and 3) recovery.