Post-road accident psychological trauma and barriers to care among survivors at Kisii level five hospital, Kisii County, Kenya
Loading...
Date
2016-10
Authors
Ogare, Samuel Oirere
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Road traffic injuries, (RTIs) are a recognized cause of physical injuries, disabilities,
mental trauma and death making it an important public health problem. Globally, RTIs
are projected to become the third leading cause of loss of healthy life and disease burden
by 2030, yet health care systems are inadequately prepared for this challenge. Kenya is
one of the countries with high RTI burden, with over 3,000 people dying annually and
survivors exerting huge burden on the health care system. Therefore, the study recruited
191 in and out patients RTI survivors to study psychological trauma and barriers to care.
Physical injuries of RTIs are known. However, the burden of psychological trauma and
barriers to care in Kisii County are largely unknown. This was a cross-sectional hospital
based study targeting survivors above 18 years of age. The Hospital was purposefully
chosen as it serves as the hospital of choice for RTI trauma care. Kisii County was
chosen because it has 8 of the II major accident black-spots in Nyanza. The study
focused on documenting social demographic characteristics, psychological trauma and
barriers to trauma care as well as establishing the relationship between sociodemographics
and psychological trauma. Data were collected by use of interview
schedule and observational checklist. It was entered into MS Excel database and analyzed
using SPSS version 15.0 statistical software. Linear chi-square was used to test for levels
of significance. Thematic analysis for qualitative data used interpretative
phenomenological analysis based on personal constructs theory. More males than
females suffered the blunt of road accidents at 67% and 33%, respectively. Majority were
aged 21-49 years old, a population that was economically productive. 70% were married;
68% had at least secondary school level of education; 52% were in informal and 18%
formal employment. Overall, survivors experienced various psychological traumas: 94%
had flashbacks and horrific memories; 91% had travel anxiety and panicky tendencies;
87% insomnia and 86% exhibited avoidance to board automobiles. Equally, survivors
encountered various barriers to trauma care, with 89% transported to hospital in public
transport; 80.1 (Yo received trauma care from lay persons. Cumulatively, 78% had trauma
services delayed; 70% sold investments and 56% borrowed to pay for trauma care. Chisquare
tests showed that avoidance behavior and travel anxiety were more significant in
out-patient than in-patients; (t = 3.8, df = 1, P = 0.00 I). It also showed that RTI
psychological trauma was significant in survivors with at least secondary level of
education compared to primary level; (X2 = 4.1, df=1 and p = 0.001). Altogether, RTIs
are major health and economic burdens. Overall, married, economically active men aged
21-49 suffered the blunt of RTIs. These study results will stimulate interest for further
research in RTI psychological trauma in other regions. Kisii County and elsewhere will
use data to develop RTI trauma care policy. Ministry of Health will utilize the data for
health promotion. Eventually, RTI Trauma care will be optimized thus improved health
care for injury survivors.
Description
A thesis submitted in partial fulfilment of the requirements for the award of the degree of master of public health (epidemiology and disease control) in the School of Public Health, Kenyatta University. October, 2016