Craig A, Elbers N A, Jagnoor J, Gopinath B, Kifley A, Dinh M, Pozzato I, Ivers R Q, Nicholas M, Cameron I D
a John Walsh Centre for Rehabilitation Research , Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney , St. Leonards , New South Wales , Australia.
b The George Institute for Global Health, Sydney Medical School, The University of Sydney , Sydney , New South Wales , Australia.
Traffic Inj Prev. 2017 Apr 3;18(3):273-280. doi: 10.1080/15389588.2016.1248760. Epub 2016 Oct 20.
The objective of this study was to investigate the psychological impact of traffic injuries in bicyclists (cyclists) in comparison to car occupants who also sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated.
An inception cohort prospective design was used. Participants included cyclists aged ≥17 years (mean age 41.7 years) who sustained a physical injury (n = 238) assessed within 28 days of the crash, following medical examination by a registered health care practitioner. Injury included musculoskeletal and soft tissue injuries and minor/moderate traumatic brain injury (TBI), excluding severe TBI, spinal cord injury, and severe multiple fractures. Assessment also occurred 6 months postinjury. Telephone-administered interviews assessed a suite of measures including sociodemographic, preinjury health and injury factors. Psychological impact was measured by pain catastrophization, trauma-related distress, and general psychological distress. The psychological health of the cyclists was compared to that of the car occupants (n = 234; mean age 43.1 years). A mixed model repeated measures analysis, adjusted for confounding factors, was used to determine differences between groups and regression analyses were used to determine contributors to psychological health in the cyclists 6 months postinjury.
Cyclists had significantly better psychological health (e.g., lower pain catastrophizing, lower rates of probable posttraumatic stress disorder [PTSD], and lower general distress levels) compared to car occupants at baseline and 6 months postinjury. Factors predictive of cyclists' psychological distress included younger age, greater perceived danger of death, poorer preinjury health, and greater amount of time in hospital after the injury.
These data provide insight into how cyclists perceive and adjust to their traffic injuries compared to drivers and passengers who sustain traffic injuries, as well as direction for preventing the development of severe psychological injury. Future research should examine the utility of predictors of psychological health to improve recovery.
本研究的目的是调查自行车骑行者（骑车人）交通伤与同样遭受交通伤的汽车乘客相比所产生的心理影响。还对预测心理困扰加剧的因素进行了调查。
采用起始队列前瞻性设计。参与者包括年龄≥17岁（平均年龄41.7岁）的骑车人，他们在事故发生后28天内受到身体伤害（n = 238），并由注册医疗保健从业者进行了医学检查。损伤包括肌肉骨骼和软组织损伤以及轻度/中度创伤性脑损伤（TBI），不包括重度TBI、脊髓损伤和严重多发骨折。受伤6个月后也进行了评估。通过电话访谈评估了一系列指标，包括社会人口统计学、伤前健康状况和损伤因素。心理影响通过疼痛灾难化、创伤相关困扰和一般心理困扰来衡量。将骑车人的心理健康状况与汽车乘客（n = 234；平均年龄43.1岁）的心理健康状况进行比较。使用调整了混杂因素的混合模型重复测量分析来确定组间差异，并使用回归分析来确定受伤6个月后骑车人心理健康的影响因素。
与汽车乘客相比，骑车人在基线和受伤6个月时的心理健康状况明显更好（例如，疼痛灾难化程度更低、创伤后应激障碍（PTSD）可能性更低以及一般困扰水平更低）。预测骑车人心理困扰的因素包括年龄较小、感知到的死亡危险更大、伤前健康状况较差以及受伤后住院时间更长。
这些数据提供了关于骑车人如何与遭受交通伤的司机和乘客相比感知和适应其交通伤的见解，以及预防严重心理伤害发展的方向。未来的研究应检验心理健康预测指标的效用，以促进康复。
