Kenardy Justin, Heron-Delaney Michelle, Hendrikz Joan, Warren Jacelle, Edmed Shannon L, Brown Erin
Recover Injury Research Centre, University of Queensland, Brisbane, Queensland, Australia; School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
School of Psychology, Australian Catholic University, Brisbane, Queensland, Australia.
J Affect Disord. 2017 May;214:8-14. doi: 10.1016/j.jad.2017.02.031. Epub 2017 Feb 28.
Diminished physical and mental health-related quality of life (HRQoL) is a common consequence of road traffic crash (RTC) injury. This study aimed to (a) determine the probable recovery trajectories in physical and mental HRQoL; (b) examine the impact of posttraumatic stress disorder (PTSD) on HRQoL scores within these trajectory groups; and (c) examine the influence of predictor covariates on trajectory group membership.
336 (63% female, M =44.72; SD =14.77) injured RTC survivors completed the SF-36v2 at approximately 6, 12, and 24 months after sustaining a RTC injury. Participants also completed telephone interviews to assess prior history of psychological disorder and current PTSD at each wave.
Three trajectories were identified for SF-36v2 Physical Component Score (PCS): "gradual recovery" (27.3%);"low but improving" (54.7%); and"severe and chronic" (17.9%). Four trajectories were defined for SF36v2 Mental Component Score (MCS): "unaffected" (19.1%);"severe but improving" (24.1%);"severe and declining" (17.3%); and"low but improving" (39.5%). A PTSD diagnosis significantly reduced SF36v2 component scores only in trajectories associated with poorer outcome. Age was predictive of trajectory group membership for PCS, whereas injury severity was predictive of trajectory group membership for MCS.
Use of a compensation seeking sample affects generalizability to the general RTC population.
This study identified a concerning subgroup of individuals who have chronic and/or declining physical and mental HRQoL that can be impacted by a diagnosis of PTSD. The development of interventions with a special focus on associated psychological injury is needed to improve the HRQoL of at-risk individuals following RTC injury.
与身心健康相关的生活质量（HRQoL）下降是道路交通事故（RTC）受伤的常见后果。本研究旨在：（a）确定身心健康HRQoL可能的恢复轨迹；（b）检查创伤后应激障碍（PTSD）对这些轨迹组内HRQoL分数的影响；（c）检查预测性协变量对轨迹组成员资格的影响。
336名（63%为女性，M = 44.72；SD = 14.77）RTC受伤幸存者在受伤后约6、12和24个月完成了SF-36v2量表。参与者还在每次随访时完成电话访谈，以评估心理障碍病史和当前的PTSD情况。
SF-36v2身体成分得分（PCS）确定了三条轨迹：“逐渐恢复”（27.3%）；“低但改善”（54.7%）；以及“严重且慢性”（17.9%）。SF-36v2心理成分得分（MCS）定义了四条轨迹：“未受影响”（19.1%）；“严重但改善”（24.1%）；“严重且下降”（17.3%）；以及“低但改善”（39.5%）。PTSD诊断仅在与较差结果相关的轨迹中显著降低了SF-36v2成分得分。年龄可预测PCS的轨迹组成员资格，而损伤严重程度可预测MCS的轨迹组成员资格。
使用寻求赔偿的样本影响了对一般RTC人群的普遍性。
本研究确定了一个令人担忧的亚组，这些个体身心健康HRQoL呈慢性和/或下降趋势，且可能受到PTSD诊断的影响。需要制定特别关注相关心理损伤的干预措施，以改善RTC受伤后高危个体的HRQoL。
