Telephone support after traffic accidents reduces problems and improves quality of life

People who were injured in road accidents had fewer problems and a much higher quality of life if they received a simple follow-up call from a nurse three weeks after being discharged from hospital, according to research in the January issue of the Journal of Clinical Nursing.

During the two-year study, researchers from Umea University in Sweden followed up 568 car occupants, cyclists and pedestrians who had attended the same emergency department after an accident.

They found that patients in the telephone support group were 35% less likely to complain of pain and discomfort than patients in the control group and that this rose to 40% when it came to car occupants. Patients who received support also reported fewer problems with anxiety, depression, everyday tasks and mobility.

The patients, who were between 18 and 70, were randomly assigned to the intervention group (288 people) or the control group (280). People with mental health problems or dementia were specifically excluded. 510 people completed the six-month study – 147 were car drivers, 178 were cyclists and 185 were pedestrians.

All the patients were asked to fill in the same quality of life questionnaire two weeks and six months after their accident.

Patients in the intervention group also received a follow-up call after three weeks. These ranged from an average of 12 minutes in the 38% of patients who didn't need advice and 24 minutes in the 62% of patients who did ask for advice.

Key findings from the nurse-led phone calls included:

• Women were more than twice as likely to seek advice as men (69% versus 31%).
• Two-thirds of the problems mentioned by the intervention group were physical, such as pain and decreased mobility, and a third were psychological, such as emotional instability and feeling tense in traffic.
• Women were almost twice as likely to report physical problems as men (66% versus 34%) and almost four times as likely to report emotional problems (79% versus 21%).
• 29% received advice on self care, 26% were advised to visit their local medical centre or hospital for further medical attention, 25% received advice on ongoing symptoms, 11% were advised to see a physiotherapist, 5% received advice on their prognosis and 4% received advice on medication like painkillers.

"The data collected two weeks and six months after the accidents showed that the intervention group had a significantly higher health-related quality of life than the control group" says lead author Carin Franzen from the Division of Surgery at the University.

"This was most noticeable in the patients who asked for, and received, advice during the follow-up phonecall from the nurse. When we looked at the different types of road users, we found that car occupants gained the greatest benefit from the phone call and reported fewer problems with pain, discomfort and usual activities than pedestrians and cyclists."

Key findings from the six-month survey included:

• Patients in the intervention group reported fewer moderate or severe problems in four of the five quality of life categories looked at. 49% had mobility problems (59% in the control group), 17% reported anxiety or depression (26%), 14% had problems with usual activities (18%) and 9% had issues with mobility (12%). Self-care was the only issue where they had slightly more problems (4% in the intervention group and 2% in the control group).
• The most significant differences were in the car group. Pain and discomfort were reported by 38% in the support group, but 63% in the control group. Anxiety and depression were 20% and 32% in the support and control groups, usual activities were 12% and 25% and mobility was 6% and 13% respectively. Self-care was 1% in both groups.

"Our study clearly demonstrates that this simple scheme, which provided nurse-led support and advice for people involved in traffic accidents, was effective and led to reduced health problems and improved quality of life" says Carin Franzen.