Post-traumatic stress impacts on quality of life in children after road traffic accidents: prospective study
Post-traumatic stress impacts on quality of life in children after road traffic accidents: prospective study
复制标题
DOI：
10.1080/00048670903001919
复制
发表时间：
2009-01-01
影响因子：
4.6
通讯作者：
Sennhauser, Felix H.
中科院分区：
文献类型：
--
作者：
Landolt, Markus A.;Vollrath, Margarete E.;Sennhauser, Felix H.
目的：对道路交通事故(RTA)后受伤儿童青少年的健康相关生活质量(HRQOL)了解较少。尽管在受伤成人中的研究结果表明，创伤后应激症状(PTSS)可能是HRQOL的重要预测因素，但这一问题从未在儿童中进行前瞻性研究。因此，本研究的目的是前瞻性地评估RTA后儿童的HRQOL，并特别研究PTSS对HRQOL的影响。方法：采用儿童创伤后应激障碍反应指数和Toegepast Natuuretenschappelijk Onderzoek-Academy emisch Ziekenhuis Leiden(TNO-AZL)儿童健康相关生活质量问卷，对68名6.5~14.5岁的儿童在术后1个月和1年进行访谈。对父母和医生进行了问卷调查。结果：11名儿童(16.2%)在1个月时出现中到重度创伤后应激反应，12名儿童(17.6%)在1岁时出现中度至重度创伤后应激反应。在1个月时，与社区样本相比，患者报告运动功能和自主性降低，情绪功能的某些部分受损。1年后，HRQOL各维度均在或高于正常范围。多因素分析显示，1个月的PTSS显著预测1年后的HRQOL。结论：这项前瞻性研究为早期PTSS对受伤儿童的HRQOL产生长期负面影响提供了证据。因此，受伤儿童回到受伤前的高质量生活质量可能不仅取决于最佳的医疗护理，而且还取决于对创伤后应激障碍的认识和及时干预。
Objective: There is little knowledge on health-related quality of life (HRQOL) of injured children and adolescents after road traffic accidents (RTA). Although findings in injured adults suggest that post-traumatic stress symptoms (PTSS) may be important predictors of HRQOL, this issue has never been prospectively examined in children. The aim of the present study was therefore to prospectively assess HRQOL in children after RTA and specifically examine the impact of PTSS on HRQOL. Method: Sixty-eight children (aged 6.5-14.5 years) were interviewed 1 month and 1 year after an RTA using the Child PTSD Reaction Index and the Toegepast Natuurwetenschappelijk Onderzoek-Academisch Ziekenhuis Leiden (TNO-AZL) Questionnaire for Children's Health-Related Quality of Life. Parents and physicians were assessed with questionnaires. Results: Eleven children (16.2%) showed moderate to severe post-traumatic stress reactions at 1 month, and 12 children (17.6%) at 1 year. At 1 month, patients reported reduced motor functioning and autonomy and impairments in some parts of emotional functioning compared to a community sample. At 1 year all dimensions of HRQOL were within or above normal ranges. Multivariate analysis indicated that PTSS at 1 month significantly predicted HRQOL at 1 year. Conclusions: This prospective study provides evidence for a long-term negative influence of early PTSS on HRQOL in injured children. The return of injured children to pre-injury HRQOL may therefore not only depend on optimal medical care but also on awareness and timely interventions regarding PTSS.