Sydney Medical School-Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia.
Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia.
BMJ Open. 2019 Apr 4;9(4):e024391. doi: 10.1136/bmjopen-2018-024391.
Psychological distress is a prevalent condition often overlooked following a motor vehicle crash (MVC), particularly when injuries are not severe. The aim of this study is to examine whether biomarkers of autonomic regulation alone or in combination with other factors assessed shortly after MVC could predict risk of elevated psychological distress and poor functional recovery in the long term, and clarify links between mental and physical health consequences of traffic injury.
This is a controlled longitudinal cohort study, with follow-up occurring at 3, 6 and 12 months. Participants include up to 120 mild to moderately injured MVC survivors who consecutively present to the emergency departments of two hospitals in Sydney and who agree to participate, and a group of up to 120 non-MVC controls, recruited with matched demographic characteristics, for comparison. WHO International Classification of Functioning is used as the framework for study assessment. The primary outcomes are the development of psychological distress (depressive mood and anxiety, post-traumatic stress symptoms, driving phobia, adjustment disorder) and biomarkers of autonomic regulation. Secondary outcomes include indicators of physical health (presence of pain/fatigue, physical functioning) and functional recovery (quality of life, return to function, participation) as well as measures of emotional and cognitive functioning. For each outcome, risk will be described by the frequency of occurrence over the 12 months, and pathways determined via latent class mixture growth modelling. Regression models will be used to identify best predictors/biomarkers and to study associations between mental and physical health.
Ethical approvals were obtained from the Sydney Local Health District and the research sites Ethics Committees. Study findings will be disseminated to health professionals, related policy makers and the community through peer-reviewed journals, conference presentations and health forums.
ACTRN12616001445460.
心理困扰是一种普遍存在的情况，在机动车碰撞（MVC）后常常被忽视，尤其是当受伤不严重时。本研究旨在探讨自主调节生物标志物单独或与 MVC 后短期评估的其他因素结合使用，是否可以预测长期心理困扰和功能恢复不良的风险，并阐明交通事故伤害对心理健康和身体健康后果之间的联系。
这是一项对照性纵向队列研究，随访时间为 3、6 和 12 个月。参与者包括最多 120 名轻度至中度 MVC 幸存者，他们连续到悉尼的两家医院急诊科就诊并同意参与，以及最多 120 名非 MVC 对照组，根据匹配的人口统计学特征招募，用于比较。世界卫生组织国际功能、残疾和健康分类被用作研究评估的框架。主要结果是心理困扰（抑郁情绪和焦虑、创伤后应激症状、驾驶恐惧症、适应障碍）和自主调节生物标志物的发展。次要结果包括身体健康指标（疼痛/疲劳、身体功能）和功能恢复（生活质量、恢复功能、参与）以及情绪和认知功能的测量。对于每个结果，将通过 12 个月内的发生频率来描述风险，并通过潜在类别混合增长模型来确定途径。回归模型将用于确定最佳预测因素/生物标志物，并研究心理健康和身体健康之间的关系。
悉尼地方卫生区和研究地点的伦理委员会已获得伦理批准。研究结果将通过同行评审期刊、会议演讲和健康论坛向卫生专业人员、相关政策制定者和社区传播。
ACTRN12616001445460。
