Road Traffic Accident Survivors Research Articles

The impact of cognitive impairment resulting from traumatic brain injury on health-related quality of life (HRQOL) in Pakistan.

Madam, Millions of people are affected by traumatic brain injury (TB) across the world each year. Road traffic accidents (RTAs) are among the top contributors of mild to severe TBI cases, and in developing countries like Pakistan, low literacy rates and lack of awareness regarding traffic rules have further aggravated the situation.(1) Many survivors of RTAs never return to their normal life and are made to live with persistent disabilities. The limitation of knowledge regarding post-TBI cognitive impairment has been noted, and it further adds a barrier to necessary actions. It's evident that following mild to moderate TBI, the patients are prone to cognitive impairment and its associated adverse effects.(2) A recent 2019 study by Gorgoraptis et al. reported that cognitive impairment adversely effects health-related quality of life (HRQOL) following TBI.(3) In Pakistan’s already struggling healthcare system, there are a few emergency trauma centres with neurocritical care units in it. Another study indicates that TBI patients are not assessed by an experienced doctor most of the time, with poor reporting of the clinical findings and hence missing out on an important finding in such patients. (4) Computed Tomography (CT) scans for critical patients are available only in large centres and patient load, and cost of investigation can hinder to its timely availability for most TBI patients. Post TBI cognitive impairment can cause a significant burden on the healthcare system leading to other social implications as well. The patients are discharged once they get stabilized with no proper follow-up plans which can lead to other avoidable cognitive impairments like dementia, psychiatric problems, and behavioural changes. In TBI cases, risk assessment and more advanced investigations like MRI can be provided to the patients who suspected of any finding missed on a CT scan. Furthermore, TBI guidelines need to be reviewed and planned accordingly. A psychiatric team must assess patient’s mental status changes during the stay and if needed proper therapy must be initiated. Neuropsychological rehabilitation plays a pivotal role in cognitive impairments and can help decrease the burden of neurological diseases (5) and improves HRQOL of patients. Hence, a unified and interdisciplinary approach towards patients with traumatic brain injury is required so that not only can mortality be reduced but also to better the quality of life in survivors.

Determinants of post-traumatic stress disorder among survivors of road traffic accidents in dessie comprehensive specialized hospital North-East Ethiopia

BackgroundPost-traumatic stress disorder is the most common mental disorder occurring among survivors of road traffic accidents. However, it remains under-explored and is not taken into account in the health policies of Ethiopia. Therefore, this study aimed to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident patients in Dessie Comprehensive Specialized Hospital, North-East Ethiopia.MethodsA facility-based unmatched case–control study design was employed from February 15 to April 25, 2021, in Dessie Comprehensive Specialized Hospital, with a total sample size of 139 cases and 280 controls selected by using a simple random sampling technique. Data were collected by pretested, interview with a structured questionnaire. The data were entered using Epi-Info, then exported and analyzed using STATA. The bi-variable and multivariable binary logistic regression model was used to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident. Adjusted odds ratio with a 95% confidence level was used as a measure of association. Variables with a p-value less than 0.05 were considered as statistically significant.ResultA total of 135 cases and 270 controls participated in this study, with a response rate of 97% and 96%, respectively. In the final multivariable analysis, being male [AOR = 0.43, 95% CI: 0.32–0.99], primary educational status [AOR = 3.4, 95% CI: 1.04–11], presence of personal psychiatric history [AOR = 2.12, 95% CI: 1.17–3.92], presence of fracture [AOR = 2.41, 95% CI: 1.2–4.8], witness of death [AOR = 2.25, 95% CI: 1.26–4.30], presence of comorbidity [AOR = 2.29, 95% CI: 1.28–4], good social support [AOR = 0.71, 95% CI: 0.12–0.68] were significantly associated with post-traumatic stress disorder among survivors of road traffic accident patients.ConclusionPTSD following road traffic accidents is common. A multi-disciplinary approach was therefore essential in the management of road traffic accident survivors at the orthopedic and trauma clinics. Patients with poor social support, bone fracture, witnessed death, comorbidity, and females should be routinely screened for post-traumatic stress disorder in all road traffic accident survivors.

Post traumatic stress disorder and the associated factors among the survivors of road traffic accident attending in a specialized hospital in Dhaka

Background: Post traumatic stress disorder (PTSD) is the most common mental disorder occurring among survivors of road traffic accidents (RTA). It could result in long-term adverse consequences if left untreated, mainly leading to social and functional impairments of RTA survivors, which finally results in a poor quality of life. Objectives: To assess the prevalence of PTSD among the RTA survivors and the associated factors of it. Materials & methods: An institution-based cross-sectional study was carried out among 202 admitted RTA patients in the inpatient department of a specialized hospital in Dhaka city for one year duration. Data were collected from these patients using a semi structured interview administered questionnaire where the Diagnostic and Statistical Manual-IV DSM-IV(PCL-S) checklist used to assess PTSD. The collected data were analyzed by using SPSS software (Version 21) and p < 0.05 considered as significant. Results: A total 202 RTA patients were included in the study and the prevalence of probable PTSD among RTA survivors was 41.1% according to DSM-IV(PCL-S) checklist. The mean age of RTA survivors found 37.6 (±13.2) years, majority 57.4% belongs to 18-30 years age group. The mean PTSD score found was 44.1(±8.2), 9.2% RTA survivors had previous history of known depressive symptoms. Among the socio-demographic attributes, age and occupation were significantly associated with the PTSD; other accident related factors like time since accident and type of accident were strongly associated with the PTSD. Conclusion: This study found a high prevalence of PTSD among RTA survivors with some associated significant sociodemographic and accident-related factors. The findings suggest a need for early screening for PTSD among the survivors of RTA. Update Dent. Coll. j: 2022; 12(2): 14-18

Study of post traumatic stress disorder among survivors of road traffic accident

Introduction: Road traffic accidents (RTAs) are a rapidly growing burden, especially in developing countries, posing a high economic burden on low- and middle-income countries. Over 50 million people worldwide experience trauma through RTA every year, it is the 3rd leading cause of disability. Objectives of our study: The objectives of our study is to estimate the prevalence of PSTD among the survivors of RTA visiting out tertiary care centre. Methodology: Demographic information, accident profile and clinical profile of the subjects included in the study were noted. Diagnosis of PSTD was based on DSM-5 diagnostic criteria for PSTD, it consisted of 20 item self-report measure, each item score ranges from 0 to 4, 0 indicates not at all, 1 indicates little bit, 2 indicates moderately, 3 indicates quite a bit and 4 indicates extremely. The total score is 80 and obtained by summing the scores of the 20 items. A cutoff score >33 was used for the provisional diagnosis of PTSD. Results: Out of the 300 subjects met with RTA, 68 subjects met the criteria of diagnosis of PTSD at 95% Confidence Interval [ CI = 22.68 - 28.54], the prevalence was found to be 22.6%.

Audit of infection and antimicrobial drug resistance pattern in bacterial infections in road traffic accident survivors

Background: In countries like India, road traffic accident (RTA) associated morbidity and mortality is rising in alarming rate and is major concern of public health. Around 80% of the late deaths in trauma patients are due to infection. This study was undertaken to study the profile of infection and drug resistance pattern of bacterial infection in RTA survivors. Materials and Methods: This was a retrospective study and was conducted at a tertiary care hospital with documented evidence of infection from the hospital records. The demographic details of the patient, details of injury and the pathogens causing infections with drug resistance patterns were studied. Results: A total of 163 patients were accrued and the majority of the patients were male (140, 85%) and around 66% belonged to the working age group, i e., 20–50 years. Most of the patient's were treated by orthopedics and surgery departments, 72% and 20%, respectively. The majority of the patients had wound infection followed by Urinary tract infection. Among the Gram-negative pathogens, Escherichia coli and Citrobacter species were the common pathogens; and among Gram-positive organisms, Enterococcus species and Staphylococcus aureus. Most of the pathogens were resistant to commonly used presurgical prophylactic antibiotics such as ampicillin, cefuroxime, and ciprofloxacin. Conclusion: The bacterial profile of the pathogens causing infection in RTA survivors may vary among different institutions. Therefore the antibiogram of these pathogens needs to be studied and analyzed by each medical facility attending to RTA survivors to formulate policy for presurgical antibiotic prophylaxis.

Proactive Interference in Posttraumatic Stress Disorder.

Deficits in working memory (WM) have a role in maintaining posttraumatic stress disorder (PTSD) symptoms, including intrusions, which are a hallmark of PTSD symptomatology. As intrusions are distressing and uncontrollable, it is important to investigate whether PTSD is associated with altered control of proactive interference in WM. Moreover, it is important to consider both verbal and visual WM, as previous research has demonstrated a visual versus verbal dissociation in PTSD. Although previous studies have explored proactive interference in visual and verbal stimuli using a recent probe task, the stimuli used thus far have been non-trauma-related. Therefore, we aimed to investigate proactive interference in PTSD using trauma-related verbal and visual stimuli. Road traffic accident (RTA) survivors with (n = 60) and without PTSD (n = 30) completed a recent probe task to assess proactive interference of visual and verbal trauma-related material. Participants with PTSD displayed significantly more proactive interference than trauma-exposed controls for visual, ηp 2 = .40, and verbal material, ηp 2 = .10, indicating that proactive interference is significantly impaired in PTSD. This demonstrates that further research is warranted and highlights the possibility of considering proactive interference of trauma-related stimuli in therapeutic approaches.

Quality of Life in Road Traffic Accident Survivors.

IntroductionThe loss of quality of life is the major consequence following a non-fatal road traffic accident (RTA). Previous research regarding quality of life did not include uninjured RTA survivors. The research aim was thus to evaluate the quality of life of the RTA survivors regardless of whether or not they sustained injures, and to identify factors associated with decreased quality of life after the RTA.MethodsA cohort of 200 RTA survivors with and without injuries was followed after experiencing an RTA. The quality of life and mental health outcomes were assessed 1 month following RTA. A vast range of sociodemographic, pre-RTA health-related, RTA related, RTA injury-related, compensation-related factors and mental health outcomes were investigated.ResultsDecreased quality of life following an RTA showed an association with the low socioeconomic status of the RTA victims, poor pre-RTA health, injury-related factors, compensation-related factors and psychological disorders after the RTA.ConclusionsIdentifying predictors of decreased quality of life following an RTA will enable planning interventions targeting the most important factors that influence recovery of RTA victims. Assessing and recording of self-reported quality of life should be a part of the routine protocol in RTA survivors’ health-care.

‘I don’t want to think about it’: Psychosocial experiences of road traffic accident survivors in Ghana

IntroductionRoad traffic injuries are among the top ten traumatic events that affect the psychosocial wellbeing and quality of life of survivors. The aim of this study was to explore the experiences of road traffic accident survivors in Ghana, a low-middle-income country in sub-Saharan Africa. MethodsThe study adopted an interpretive qualitative research design. Thirteen (13) participants were purposively selected from the Accident Centre of the largest public teaching hospital in Ghana. Data collection employed in-depth face-to-face interviews using a semi-structured guide. Data analysis occurred concurrently using thematic analysis methods. The right to participate or withdraw from study was protected. FindingsThree major themes deductively generated from the research were cognitive experiences, affective responses and social experiences of Road Traffic Accident survivors. Nearly all survivors of road traffic accidents experience repetitive episodes of intrusive thoughts, nightmares, anxiety and other extreme emotions suggesting post-traumatic stress, which is often unrecognized. ConclusionImmediate reactions of survivors of road traffic accident are affected by their experiences, accessibility of support, and the responses of the larger community. We propose that a focused assessment and management of accident survivors for post-traumatic disorder be included in existing care modalities to promote a holistic care and recovery for survivors.

Mental health outcomes in road traffic accident survivors: prospective cohort study

Abstract Background Mental health outcomes of road traffic accidents (RTAs) are always investigated amongst the injured. The aim of this study was to investigate psychological consequences and associated factors in all RTA survivors irrelevant of their injury status. Methods A cohort of 200 Croatian RTA survivors was assessed one month after experiencing a RTA using the posttraumatic stress disorder (PTSD) Checklist for civilians, the Beck Depression Inventory and the Beck Anxiety Inventory. The New Injury Severity Scale was used for the injury severity assessment. Results RTA survivors reported substantial rates of PTSD (35.5%) and depression (20.0%) symptoms, and low rates of anxiety (4.5%). Symptoms of depression were associated with under-average self-perceived economic status (SES) (P = 0.001), irreligiousness (P = 0.001), medication use (P < 0.001), injury severity (P < 0.001), self-perceived threat to life (P < 0.022), hospitalization (P = 0.003), hospitalization duration (P = 0.004), surgical treatment of the injury (P < 0.001), unconsciousness in the RTA (P = 0.033) and post-RTA amnesia (0.039). PTSD symptoms were associated with unemployment (P = 0.034), under average SES (P = 0.004), lack of previous RTA experience (P = 0.025), previous psychiatric illness (P = 0.001), medication use (P = 0.001), psychiatric medication use (P < 0.001), injury affliction (P = 0.001), injury severity (P < 0.001), self-perceived threat to life (P < 0.001), pain after RTA (P = 0.009), hospitalization duration (P = 0.017) and claiming compensation (P = 0.008). Anxiety symptoms were associated with previous chronic (P = 0.037) or psychiatric illness (P = 0.010), previous permanent pain (P < 0.001), psychiatric medication use (P = 0.013) and rehabilitation after injury (P = 0.032). Conclusions A RTA is a traumatic event that can result in physical injuries, but also with psychological consequences depending on pre-RTA survivor's characteristics. Psychological support to those at risk may prevent psychological disorders after a RTA. Key messages Along with evaluation and treatment of road traffic accidents injuries, health care providers should evaluate pre-accident health status of all road traffic accidents victims. Understanding factors that present risk for poor mental health outcomes after the road traffic accidents is the key step in planning and organizing recovery of accidents survivors.

Prevalence and determinants of post-traumatic stress disorder among road traffic accident survivors: a prospective survey at selected hospitals in southern Ethiopia

BackgroundPost-traumatic stress disorder (PTSD) is prevalent among road traffic accident survivors (RTA), yet the psychological welfare of the persons has largely been ignored as health care professionals focus more on managing physical injuries. Many literatures from other parts of the world have addressed the issue of post-traumatic stress disorder among road traffic accident survivors, but such studies are mostly unavailable in sub-Saharan Africa, especially in Ethiopia. Therefore, this study examined the prevalence and determinants of PTSD among RTA survivors attending selected hospitals in southern Ethiopia.MethodsInstitution based cross-sectional study design was employed from April 1/2018-Sep 30/2019. Data were collected from a sample of consecutively selected 423 RTA survivors through an interviewer-administered technique. A pre-tested post-traumatic stress disorder Checklist-Specific version (PCL-S) tool was used to screen PTSD. Data were entered and analysed using SPSS 22 software. A logistic regression model was fitted to identify determinants of PTSD. An adjusted odds ratio (AOR) with a 95% confidence interval was computed to determine the level of significance with a p-value of less than 0.05.ResultA total of 416 participants were included in the study and the response rate was 98.6%. The prevalence of probable PTSD among RTA survivors was 15.4% (64). After adjusting for the effects of potential confounding variables; time since accident (30–90 days) (AOR = 0.33; 95%CI (0.15, 0.73), history of previous road traffic accident (AOR = 2.67; 95%CI (1.23, 5.77), depressive symptoms (AOR = 2.5, 95% CI (1.10, 6.10)) and common mental disorder (AOR = 12.78, 95% CI (5.56, 29.36)) were significant determinants of PTSD.ConclusionThe prevalence of probable PTSD in the current study was high (15.4%). Time since accident, history of a previous road traffic accident, having depressive symptoms and common mental disorder were significant determinants of PTSD. RTA survivors attending adult Emergency and orthopedic clinics need to be screened for PTSD and get appropriate management.

Predictors of Mental Health Outcomes in Road Traffic Accident Survivors.

Mental health outcomes of road traffic accidents (RTAs) are always investigated in assessments of those involved. The aim of this study was to investigate the psychological consequences and associated factors in all RTA survivors, irrelevant of their injury status. A cohort of 155 people was assessed one month after experiencing a RTA using self-reported measures for posttraumatic stress disorder (PTSD), depression, and anxiety. Associations between mental health outcomes and sociodemographic factors, pre-RTA health status, injury-related factors, and RTA details were analyzed. RTA survivors reported substantial rates of PTSD (32.3%) and depression (17.4%) symptoms, and low rates of anxiety (5.8%). Symptoms of depression were associated with below-average self-perceived economic status, irreligiousness, medication use, psychiatric medication use, and injury-related factors. PTSD symptoms were associated with female gender, below-average self-perceived economic status, previous psychiatric illness, medication use, psychiatric medication use, not being at fault in the relevant RTA, claiming compensation, and injury-related factors. Anxiety symptoms were associated with previous chronic or psychiatric illness, previous permanent pain, psychiatric medication use, and self-perceived threat to life, but not with sustaining injury. Along with the evaluation and treatment of RTA injuries, health care providers should evaluate the pre-RTA health status of all RTA victims. Psychological support to those at risk may prevent psychological disorders after RTAs.

The prevalence of apathy among road traffic accident survivors

The prevalence of apathy among road traffic accident survivors

Assess the impact of post traumatic stress disorder in road traffic accident survivors in Erode district, Tamil nadu

Assess the impact of post traumatic stress disorder in road traffic accident survivors in Erode district, Tamil nadu

Čimbenici povezani s osljedama u cestovnom prometu i njihovom težinom

Road traffic injuries cause considerable losses to individuals, their families, and to nations as a whole. Factors related to road traffic injuries and to the severity of such injuries have not been fully elucidated or evaluated. The aim of this study was to explore factors related to road traffic injuries and their severity in cohort of 200 road traffic accident (RTA) survivors from Eastern Croatia. Sustaining injury was associated with rural residence (p=0.032), lower education level (p=0.001), unemployment (p=0.001), being single (p=0.014), under average self-assessed economic status (p=0.001), alcohol abstinence (p=0.018), use of medications (p=0.031), self-assessed life-threat (p<0.001), pain after the RTA (p<0.001), hospitalization after the RTA (p<0.001), hospitalization duration (p<0.001), surgery (p=0.048), rehabilitation following the RTA (p=0.001) and PTSD symptoms (p=0.001). Injury severity was associated with lower education level (p=0.013), unemployment (p=0.004), being single (p=0.017), under average self-assessed economic status (p<0.001), alcohol abstinence (p=0.042), use of medications (p=0.014), self-assessed life-threat (p<0.001), pain after the RTA (p<0.001), being a pedestrian or a cyclist (p=0.011), hospitalization after the RTA (p<0.001), hospitalization duration (p<0.001), surgery (p<0.001), rehabilitation following the RTA (p=0.001), depression (p<0.001) and PTSD symptoms (p<0.001). In order to more adequately prevent road traffic injuries knowledge about factors associated with such injuries and their severity should be base for the creation of specific prevention programs at regional and national level.

Incidence of Post-Traumatic Stress Disorder After Road Traffic Accident.

Background: Post-traumatic stress disorder (PTSD) occurs after exposure to actual or threatened death, serious injury, or sexual violence. Road traffic accident (RTA) is one of the traumatic experiences, which may result in PTSD. But treatment is mainly concentrated on physical health. This may be due to a lack of evidence in low-income countries. Aim: To determine the incidence level and identify risk factors of PTSD after RTA. Methods: Longitudinal panel study was done to assess the incidence of PTSD after RTA. The study was conducted in three orthopedic settings of Bahir Dar town Northwest, Ethiopia. The study was on 299 adult car accident survivors. PTSD Checklist (PCL) civilian version, Sheehan disability assessment scale, Patient Health Question (PHQ-2), and Alcohol Use Disorder Identification Test (AUDIT) were instruments to assess the outcome and associated factors. The generalized linear model with Poisson log-linear method was applied to identify associated factors. Ethical clearance was obtained from Bahir Dar University. Individuals with PTSD symptoms were linked to the psychiatric clinic. Result: One hundred thirty-nine (46.5%) participants had at least three extremely severe symptoms that fulfil criteria B, C, and D of Diagnostic Statistical Manual IV of PTSD. The most frequent severe symptoms were having repeated, disturbing memories, thoughts, or images. Two hundred ten (70.2%) participants reported the extreme impact of the accident on work or schooling and 156 (51.9%) reported extreme problems in social functioning. Alcohol dependence, hazardous alcohol consumption, and harmful use were reported by 7.9%, 15.1%, and 4.7% of the participants, respectively. In the final model witnessing death, severe sleep problem and severe impairment in family functioning were significantly associated with PTSD. Conclusion: Nearly half of RTA survivors develop PTSD. Clinicians need to link these patients to the psychiatry clinic. Special attention should be given to patients who witnessed death, with a serious disability, and previous psychiatric history.

Post-Traumatic Stress Disorder in Road Traffic Accident Survivors – Can We Do More?

Post-Traumatic Stress Disorder in Road Traffic Accident Survivors – Can We Do More?

Prevalence and correlates of post-traumatic stress disorder among survivors of road traffic accidents in Ethiopia

BackgroundPost-traumatic stress disorder is the most common mental disorders occurring among survivors of road traffic accident. However, research into post-traumatic stress disorder and correlates in low and middle-income countries is limited. To the best of our knowledge, there is no published study of the post-traumatic stress disorder and associated factors conducted in Ethiopia. Therefore, this study aimed to determine the prevalence of post-traumatic stress disorder and associated factors among survivors of road traffic accident.MethodsInstitution based cross-sectional study was conducted in May 2016. Data were collected using a pretested, structured, standardized post-traumatic stress disorder Checklist-Specific version (PCL-S) questionnaire. Systematic sampling technique was used to select the study participants. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of associations.ResultsThe prevalence of post-traumatic stress disorder was found to be 22.8% (CI 19.2, 26.6) among survivors of road traffic accident. In the multivariable analysis, Being female [AOR = 2.23, 95% CI 1.40, 3.56], having poor social support [AOR = 2.1, 95% CI 1.34, 3.46], duration since accident (1–3 months) [AOR = 1.72, 95% CI 1.07, 2.76] and having depression [AOR = 3.46, 95% CI 1.99, 5.99] were significantly associated with PTSD among survivors of road traffic accident.ConclusionIn the current study the magnitude of post-traumatic stress disorder was high. Being female, poor social support, duration since the accident (1–3 months) and depression were found to be significant predictors of post-traumatic stress disorders. The finding suggests a need for early screening for post-traumatic disorder among survivors of road traffic accidents.

Prevalence of acute stress disorder among road traffic accident survivors: a meta-analysis

BackgroundRoad traffic accident (RTA), an unexpected traumatic event, may not only lead to death and serious physical injuries, but also could put survivors at an increased risk for a wide range of psychiatric disorders, particularly acute stress disorder (ASD). Early assessment of trauma-related psychological responses is important because acute trauma responses in the early post-traumatic period are among the robust predictors of long-term mental health problems. However, estimates of the prevalence of ASD among RTA survivors varied considerably across studies. Therefore, this meta-analysis aimed to identify the pooled prevalence of ASD among RTA survivors.MethodsA systematic literature search in the databases of PubMed, PsycINFO, PsycARTICLES, Embase and Web of Science was performed from their inception dates to December 2017. Subject headings were used to identify relevant articles, and the search strategy was adjusted across databases. Heterogeneity across studies was evaluated by Cochran’s χ2 test and quantified by the I2 statistic. Subgroup analyses were performed to identify the pooled prevalence in relation to the country of study, instrument used to identify ASD, age, gender and traumatic brain injury. When significant heterogeneity was observed, the influence of some potential moderators was explored using meta-regression analyses.ResultsThirteen eligible studies conducted in 8 countries were included. A total of 2989 RTA survivors were assessed, of which 287 were identified with ASD. The overall heterogeneity was high across studies (I2=96.8%, P < 0.001), and the pooled prevalence of ASD among RTA survivors was 15.81% (95% confidence interval: 8.27–25.14%). Subgroup analyses indicated that the prevalence of ASD among RTA survivors differed significantly with regard to the country of study, instrument used to identify ASD, age and gender (P < 0.05). Meta-regression analyses showed that mean age of participants and quality assessment score were significant moderators for heterogeneity (P < 0.05).ConclusionsNearly one-sixth of RTA survivors suffer from ASD, indicating the need for regular assessment of early trauma responses among RTA survivors, as well as the importance of implementing early psychological interventions.

Prevalence of posttraumatic stress disorder among road traffic accident survivors: A PRISMA-compliant meta-analysis.

Background:Involvement in road traffic accidents (RTAs) may put individuals at increased risk for a wide range of psychiatric disorders, among which posttraumatic stress disorder (PTSD) presents a public health issue. However, a great disparity was observed among studies exploring the prevalence of PTSD among RTA survivors. This meta-analysis aimed to explore the pooled prevalence of PTSD among RTA survivors.Methods:Electronic databases of PubMed, Embase, Web of Science, PsycARTICLES, PsycINFO, and CINAHL were searched to identify relevant studies. Study selection and data extraction were conducted independently by 2 investigators, and a meta-analysis was performed to synthesize the data. Heterogeneity among studies was evaluated using the Cochran Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify the source of the heterogeneity. The possibility of publication bias was assessed using Egger linear test.Results:Fifteen eligible studies containing 6804 RTA survivors were identified in this meta-analysis, of which 1489 were identified with PTSD. The pooled prevalence of PTSD among RTA survivors was 22.25% (95% confidence interval: 16.71%–28.33%). A high degree of heterogeneity was observed across studies (I2 = 97.1%, P < .001), with reported PTSD prevalence ranging from 6.3% to 58.3%. Subgroup analyses found that the prevalence of PTSD among RTA survivors varied significantly across studies in relation to the instrument used to assess PTSD, country, race, gender, and education level (P < .05).Conclusion:The high pooled prevalence of PTSD among RTA survivors found in this study significantly underscores the need for providing timely and effective intervention strategies for RTA survivors.

Impact of 'Adl Self-Management Module' on Health Related Quality of Life Among Road Traffic Accidents’ Patients: A Quasi-Experimental Research Approach

Background: Road traffic accidents represent a community and governmental concern in Saudi Arabia and worldwide. In addition, road traffic accidents injuries are among the main causes of physical impairment and functional dependency. Therefore, performance of activity of daily living of those injured patients are severely affected due to loss of independence. Subsequently, quality of life is affected as well. Objective: To develop, implement and evaluate the impact of “ADL self-management module” on health related quality of life among road traffic accidents’ patients. Methods/design: A quasi experimental study design will be conducted in Saudi Arabia in which 152 orthopedic patients with lower extremities fractures due to road traffic accidents who have difficulty in carrying out daily activity will be recruited from the study hospitals based on Barthel Index. The patients in the intervention group will provided with the ADL Self-Management Module in a form of an educational material. They will be supplemented in that module with knowledge, skills and confidence to engage in self-management of activity of daily living tasks independently, whereas the control group will receive the usual care. Descriptive analysis, chi square and Generalized Estimation Equation, Independent t test will be used to test the differences of activity of daily living and health related quality of life between and within the groups. Discussion: To our knowledge, this is the first experimental study that will conducted in Saudi Arabia on ADL self-management to improve the quality of life of Road Traffic Accident survivors who have difficulty in performing daily activities.