Littleton S M, Hughes D C, Poustie S J, Robinson B J, Neeman T, Smith P N, Cameron I D
College of Medicine, Biology and Environment, Australian National University, Australia.
Injury. 2014 Jan;45(1):304-11. doi: 10.1016/j.injury.2012.06.005. Epub 2012 Jul 5.
To compare the health status of people with minor injuries from road traffic crashes that are exposed to an early, active intervention programme (intervention group) with those receiving usual care (control group) over a 12 month period.
Prospective comparative study using sequential cohorts.
People presenting to hospital emergency departments with mild to moderate musculoskeletal injuries following road traffic crashes.
Physical Component Score (PCS) and Mental Component Score (MCS) of the Short Form 36 (SF-36) health status measure; Hospital Anxiety and Depression Scale (HADS) and the Functional Rating Index (FRI) recorded immediately post-crash, at 6 months and at 12 months after injury.
There were 95 participants allocated to the control group and 98 allocated to the intervention group. Participants were enrolled at a mean of 9.3 days following the crash. There were no significant differences in baseline health measures between the groups. Apart from a small improvement in anxiety for the intervention group, there were no significant differences in health status between the groups. Twenty percent of participants in the intervention group received treatment from external healthcare providers that was inconsistent with the recommendations of the intervention programme.
The intervention programme failed to result in a clinically significant improvement in health outcomes compared with usual care. There is some evidence to suggest that the intervention had some psychological benefits, as evidenced by the small improvement in anxiety levels. Limited adherence, frequent use of co-interventions, or other factors (such as intervention content or intensity) may have reduced its effect.
比较道路交通事故轻伤患者中，接受早期积极干预方案（干预组）与接受常规护理（对照组）的患者在12个月期间的健康状况。
采用序贯队列的前瞻性比较研究。
道路交通事故后因轻至中度肌肉骨骼损伤而前往医院急诊科就诊的患者。
健康状况测量简表36（SF - 36）的身体成分得分（PCS）和心理成分得分（MCS）；在事故发生后即刻、受伤后6个月和12个月记录医院焦虑抑郁量表（HADS）和功能评定指数（FRI）。
95名参与者被分配到对照组，98名被分配到干预组。参与者在事故发生后平均9.3天入组。两组之间的基线健康指标无显著差异。除了干预组的焦虑有小幅改善外，两组之间的健康状况无显著差异。干预组中有20%的参与者接受了与干预方案建议不一致的外部医疗服务提供者的治疗。
与常规护理相比，干预方案未能在健康结局方面带来具有临床意义的改善。有一些证据表明干预有一些心理益处，焦虑水平的小幅改善证明了这一点。依从性有限、频繁使用联合干预措施或其他因素（如干预内容或强度）可能降低了其效果。
