Thesis (Ph. D.)--Auburn University, 2008. / Abstract. Vita. Includes bibliographical references (p. 49-57).

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Objectives: - The present research attempts to elicit children's perceptions and experiences of enduring a road traffic accident (RTA). It also examined their parents experiences of parenting such children and their own experiences and perceptions of the accident. Participants: - The study focussed on 14 children, aged from 9 years 9 months - 14 years and 4 months of age who had endured a RTA from between 9-33 months previously and their parents. Design: - The study employed a non-experimental design with a combination of quantitative and qualitative paradigms. Method: - The participants were identified via the hospital database of all children who had endured a RTA from between 6-24 months previously. Both the children and their parents were interviewed on specifically designed semi-structured interview schedules. Each interview was then tape-recorded and transcribed in its entirety. These transcripts then provided the universe of material for subsequent qualitative analysis. Results:- The results of this study demonstrated that approximately half of the children who had experienced a RTA were suffering from a post traumatic stress disorder (PTSD). In addition, the PTSD case children differed from the non-case children on factors such as awareness of the inpending RTA, feelings of self-blame regarding the accident, and more negative thoughts regarding their experience immediately after the impact and at the time of the assessment. In addition, the parents of the case children displayed similar responses to that of their children. Conclusion: - A theoretical Model was presented to account for the main findings in response to the research questions, also drawing on existing research. It is emphasised that this model is speculative due to the small sample size insofar as it draws upon the present findings, and as such can only relate to this study sample and further research would be required to fully test and validate it. In addition, recommendations were made for service delivery and clinical practice.

Thesis (M.A.)--York University, 2008. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references (leaves 82-85). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR46025

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Introduction: Psychological disturbances after combat and major civil accident has long been recognised, but it has become clear that more "everyday" trauma such as road traffic accidents can lead to similar problems. Post-traumatic Stress Disorder (PTSD) is the extreme of a spectrum of Post-traumatic Psychopathology (PTP), is known to influence the Metabolic Response to Trauma (MRT), and may affect physical recovery after injury. This thesis details the results of a large study of accident victims, following their physical, physiological and psychological recovery. Methods: Cohort study of 200 patients aged 16-60 y with musculoskeltal injuries. The patients completed questionnaires that examined their psychological health (GHQ), and their physical and pyschosocial health (SIP, SF-36, MFA), and trauma scores were calculated. Assessments were made on admission (<i>vice</i> health before the accident), and were repeated at two and six months. A subgroup of 82 patients also gave blood samples at each of the follow up points, and these were analysed for pro-inflammatory markers of the MRT (CRP, IL-6, soluble IL-6 receptor, and TNF-a). Results: Follow up was 79% and 75% at two and six months for the main group, and 82% and 59% respectively for the Metabolic Markers subgroup. PTP was found in 11% of patients at initial assessment, 46% at two months and 22% at six months. It was strongly related to impaired physical and psychosocial functioning There were also associations between PTP and sIL-6r and TNF-a at six months. Injury Severity Score was predictive of PTP at two and six months. Discussion: There are strong associations between psychological and physical health after musculosketal trauma. Injury Severity Score is predictive of this psychological disturbance, which is also associated with disturbance of pro-inflammatory markers. Truly holistic care of patients who have suffered musculoskeletal trauma must include management of the psychological injury as well as the more obvious physical injuries.

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