Evans S A
Division of Public Health, Nuffield Institute for Health, University of Leeds, UK.
Inj Prev. 2001 Sep;7(3):172-5. doi: 10.1136/ip.7.3.172.
It is argued that use of the term "accident" has a negative effect on prevention efforts as the term implies that such events are due to chance.
To test the hypothesis that use of "injury" in place of "accident" can influence professional attitudes towards "accident/injury" prevention.
Leeds Health Authority area serving the population (n=740,000) of the city of Leeds in the Yorkshire region of England.
A randomised comparative study. Altogether 183 health visiting staff in the Leeds area were randomised (by place of work) to one of two groups. Each group received a similar postal questionnaire assessing attitudes relating to accident/injury prevention. One group received a questionnaire using only accident terminology while the other used injury terminology throughout.
Fifty responses in the accident group were received and 39 in the injury group. Analysis by Mann-Whitney U tests showed little difference in group responses. The only significant finding was that respondents in the "accident" group were more likely to rank "accident prevention" of higher importance relative to respondents in the "injury" group (median 2, 25%-75% quartiles 1.8-4.0 compared with median 4, 25%-75% quartiles 2.0-5.0, p=0.04). However, this may have been a chance finding due to the multiple comparisons made.
This study has shown little difference in health visitor responses when "accident" is replaced with "injury". It is possible that the effect of changing terminology is more nebulous--influencing society at large. However, it would be as well to recognise the lack of evidence and clarity relating to the terminology debate. Otherwise, there is a danger that the "injury" believers may become alienated from the "accident" diehards.
有人认为使用“事故”一词对预防工作有负面影响，因为该词意味着此类事件是偶然发生的。
检验用“伤害”取代“事故”这一假设能否影响专业人员对“事故/伤害”预防的态度。
为英格兰约克郡利兹市（人口740,000）提供服务的利兹卫生局辖区。
一项随机对照研究。利兹地区总共183名健康访视工作人员（按工作地点）被随机分为两组。每组都收到一份类似的邮寄问卷，评估与事故/伤害预防相关的态度。一组收到的问卷仅使用事故术语，而另一组自始至终使用伤害术语。
事故组收到50份回复，伤害组收到39份回复。通过曼-惠特尼U检验分析发现两组回复差异不大。唯一显著的发现是，相对于“伤害”组的受访者，“事故”组的受访者更倾向于将“事故预防”列为更高的重要性（中位数为2，25%-75%四分位数为1.8-4.0，而“伤害”组中位数为4，25%-75%四分位数为2.0-5.0，p=0.04）。然而，由于进行了多次比较，这可能是一个偶然发现。
本研究表明，用“伤害”取代“事故”时，健康访视人员的回复差异不大。改变术语的影响可能更模糊——影响整个社会。然而，也应认识到与术语辩论相关的证据不足和不明确性。否则，存在“伤害”支持者可能与“事故”顽固派疏远的风险。
