Objectives: To examine children's reports of their health-related quality of life (HRQoL) following paediatric traffic injury, to explore child and parental post-traumatic stress, and to identify children and parents with adverse outcomes.
Design: Prospective cohort study. Assessments: shortly after the injury, three months and six months post injury.
Setting: Department of Traumatology, University Hospital.
Subjects: Fifty-one young traffic injury victims aged 8-15 years.
Main measures: TNO-AZL Children's Quality of Life questionnaire and the Impact of Event Scale.
Results: Short-term adverse changes in the child's HRQoL were observed for the child's motor functioning and autonomy. At three months, 12% of the children and 16% of the parents reported serious post-traumatic stress symptoms. Increased stress at three months, or across follow-up, was observed among hospitalized children, children with head injuries, and children injured in a motor vehicle accident. Parental stress was related to low socioeconomic status and the seriousness of the child's injury and accident (hospitalization, head injury, serious injury, motor vehicle involved, others injured).
Conclusions: The children reported only temporary effects in their motor functioning and autonomy. Post-traumatic stress symptoms following paediatric traffic injury were not only experienced by the children, but also by their parents.
Get full access to this article
View all access options for this article.
References
1.
1 Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health2000; 90: 523-526.
2.
2 Lescohier I, DiScala C. Blunt trauma in children: causes and outcomes of head versus extracranial injury. Paediatrics1993; 91: 721-725.
3.
3 Gofin R, Adler B, Hass T. Incidence and impact of childhood and adolescent injuries: a populationbased study. J Trauma1999; 47: 15-21.
4.
4 Aitken ME, Jaffe KM, DiScala C, Rivara FP. Functional outcome in children with multiple trauma without significant head injury. Arch Phys Med Rehabil1999; 80: 889-895.
5.
5 Harris BH, Schwaitzberg SD, Seman TM, Herrmann C. The hidden morbidity of paediatric trauma. J Pediatr Surg1989; 24: 103-105.
6.
6 Basson MD, Guinn JE, McElligott J, Vitale R, Brown W, Fielding LP. Behavioral disturbances in children after trauma. J Trauma1991; 31: 1363-1368.
7.
7 Wesson DE, Scorpio RJ, Spence LJ et al. The physical, psychological, and socioeconomic costs of paediatric trauma. J Trauma1992; 33: 252-255.
8.
8 Hu X, Wesson DE, Logsetty S, Spence LJ. Functional limitations and recovery in children with severe trauma: a one-year follow-up. J Trauma1994; 37: 209-213.
9.
9 Stancin T, Taylor HG, Thompson GH, Wade S, Drotar D, Yeates KO. Acute psychosocial impact of paediatric orthopedic trauma with and without accompanying brain injuries. J Trauma1998; 45: 1031-1038.
10.
10 Stancin T, Drotar D, Taylor HG, Yeates KO, Wade SL, Minich NM. Health-related quality of life of children and adolescents after traumatic brain injury. Paediatrics2002; 109: E34-E34.
11.
11 Sturms LM, van der Sluis CK, Groothoff JW, Eisma WH, ten Duis HJ. The health-related quality of life of paediatric traffic victims. J Trauma2002; 52: 88-94.
12.
12 Eiser C, Morse R. Quality-of-life measures in chronic diseases of childhood. Health Technol Assess2001; 5: 1-157.
13.
13 Stallard P, Velleman R, Baldwin S. Prospective study of post-traumatic stress disorder in children involved in road traffic accidents. BMJ1998; 317: 1619-1623.
14.
14 De Vries AP, Kassam AN, Cnaan A, Sherman SE, Gallagher PR, Winston FK. Looking beyond the physical injury: posttraumatic stress disorder in children and parents after paediatric traffic injury. Paediatrics1999; 104: 1293-1299.
15.
15 Keppel-Benson JM, Ollendick TH, Benson MJ. Post-traumatic stress in children following motor vehicle accidents. J Child Psychol Psychiatry2002; 43: 203-212.
16.
16 Landolt MA, Boehler U, Schwager C, Schallberger U, Nuessli R. Post-traumatic stress disorder in paediatric patients and their parents: an exploratory study. J Paediatr Child Health1998; 34: 539-543.
17.
17 Winston FK, Kassam-Adams N, Vivarelli-O'Neill C et al. Acute stress disorder symptoms in children and their parents after paediatric traffic injury. Paediatrics2002; 109: e90-e90.
18.
18 Commission on Professional and Hospital Activities. The International Classification of Disease, 9th Revision-Clinical Modification (ICD-9CM). Ann Arbor, MI: Commission on Professional and Hospital Activities, 1978.
19.
19 Baker SP, O'Neill B, Haddon W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma1974; 14: 187-196.
20.
20 Vogels T, Verrips GHW, Koopman HM, Theunissen NCM, Fekkes M, Kamphuis RP. TACQOL manual: parent form and child form. Leiden: Leiden Center for Child Health and Paediatrics LUMC-TNO, 2000.
21.
21 Theunissen NC, Vogels TG, Koopman HM et al. The proxy problem: child report versus parent report in health-related quality of life research. Qual Life Res1998; 7: 387-397.
22.
22 Verrips EGH, Vogels TGC, Koopman HM et al. International child health. Measuring health-related quality of life in a child population. Eur J Public Health1999; 9: 188-193.
23.
23 Horowitz M, Wilner N, Alvarez W, Yule W, Williams RM. Impact of Event Scale: a measure of subjective stress. Psychosom Med1979; 41: 209-218.
24.
24 Brom D, Kleber RJ. De Schok Verwerkings Lijst (The Dutch version of the Impact of Event Scale). Ned Tijdschr Psychol1985; 40: 164-168.
25.
25 Yule W, Williams RM. Post-traumatic stress reactions in children. J Trauma Stress1990; 3: 279-295.
26.
26 Yule W, Udwin O. Screening child survivors for post-traumatic stress disorders: experiences from the ‘Jupiter’ sinking. Br J Clin Psychol1991; 30: 131-138.
27.
27 Dyregrov A, Kuterovac G, Barath A. Factor analysis of the impact of event scale with children in war. Scand J Psychol1996; 37: 339-350.
28.
28 Canterbury J, Yule W. The effects on children of road accidents. In: Mitchell M ed. The aftermath of road accidents. London: Routledge, 1997.
29.
29 McDermott BM, Cvitanovich A. Posttraumatic stress disorder and emotional problems in children following motor vehicle accidents: an extended case series. Aust N Z J Psychiatry2000; 34: 446-452.
30.
30 Sturms LM, van der Sluis CK, Groothoff JW, ten Duis HJ, Eisma WH. Young traffic victims' long-term health-related quality of life: child self-reports and parental reports. Arch Phys Med Rehabil2003; 84: 431-436.
31.
31 Yule W. Treatment of PTSD in children following road traffic accidents. In: Hickling E, Blanchard E eds. The international handbook of road traffic accidents and psychological trauma: current understanding, treatment and law. Oxford: Elsevier Science, 1999.
32.
32 Nader K, Pynoos R, Fairbanks L, Frederick C. Children's PTSD reactions one year after a sniper attack at their school. Am J Psychiatry1990; 147: 1526-1530.
33.
33 Famularo R, Fenton T, Augustyn M, Zuckerman B. Persistence of paediatric post traumatic stress disorder after 2 years. Child Abuse Negl1996; 20: 1245-1248.
34.
34 Beers SR, De Bellis MD. Neuropsychological function in children with maltreatment-related posttraumatic stress disorder. Am J Psychiatry2002; 159: 483-486.
35.
35 American Psychiatric Association. Diagnostic and statistical manual of mental disorders-fourth edition (DSM-IV). Washington, DC: APA, 1994.
36.
36 Joseph S. Psychometric evaluation of Horowitz's Impact of Event Scale: a review. J Trauma Stress2000; 13: 101-113.
37.
37 Sundin EC, Horowitz MJ. Impact of Event Scale: psychometric properties. Br J Psychiatry2002; 180: 205-209.
38.
38 Yule W, Williams R, Joseph S. Post-traumatic stress disorders in adults. In: Yule W ed. Post-traumatic stress disorders: concepts and therapy. Chichester: Wiley, 1999.
39.
39 Di Gallo A, Barton J, Parry JW. Road traffic accidents: early psychological consequences in children and adolescents. Br J Psychiatry1997; 170: 358-362.
40.
40 Mirza KA, Bhadrinath BR, Goodyer IM, Gilmour C. Post-traumatic stress disorder in children and adolescents following road traffic accidents. Br J Psychiatry1998; 172: 443-447.
41.
41 Bryant RA. Posttraumatic stress disorder and traumatic brain injury: can they co-exist?Clin Psychol Rev2001; 21: 931-948.
42.
42 Max JE, Castillo CS, Robin DA et al. Posttraumatic stress symptomatology after childhood traumatic brain injury. J Nerv Ment Dis1998; 186: 589-596.
43.
43 Levi RB, Drotar D, Yeates KO, Taylor HG. Posttraumatic stress symptoms in children following orthopedic or traumatic brain injury. J Clin Child Psychol1999; 28: 232-243.
44.
44 Figley CR, Kleber RF. Beyond the‘victim’: secondary traumatic stress. In: Kleber RJ, Figley CR, Gersons BPR eds. Beyond trauma: cultural and societal dynamics. New York: Plenum Press, 1995: 75-98.
45.
45 Foy DW, Madvig BT, Pynoos RS, Camilleri AJ. Etiologic factors in the development of posttraumatic stress disorder in children and adolescents. J School Psychol1996; 34: 113-145.
46.
46 Winje D, Ulvik A. Long-term outcome of trauma in children: the psychological consequences of a bus accident. J Child Psychol Psychiatry1998; 39: 635-642.
47.
47 Scheeringa M, Zeanah CH. A relational perspective on PTSD in early childhood. J Trauma Stress2001; 14: 799-815.
