Abstract
M.A.
A review of existing relevant literature and research confirms that there is not always unanimity about the diagnosis and classification of the Post-concussion syndrome (PCS). This controversy arising from the diagnosis results in the failure to inform, prepare and equip the patient and his family adequately for the effects of PCS. This influences the treatment and eventual rehabilitation of a patient who has a light head injury.
It is, therefore, essential that the medical field, over the whole spectrum of medical
disciplines, should fully understand PCS and the patient, and should also provide the patient's support system with the necessary information with regard to the effects of PCS. This will, in truth, affect the rehabilitation of this patient.
An investigation of the literature showed that most light head injuries are the result
of road accidents, followed by industrial and factory accidents. Other types of head injuries and alcohol abuse play a further role in the appearance and degree of seriousness of light head injuries.
The effect of PCS symptoms range from physical discomforts such as headaches
to more emotional problems such as depression, fatigue, anxiety and concentration
problems. Primary symptoms fade with the passing of time while secondary
symptoms increase after the first few months after the head injury. The experience
of PCS symptoms can be influenced by different factors such as pre-trauma
personality traits, accident neurosis and compensations. It is postulated that the
experience of typical PCS symptoms can be mediated by sufficient understanding,
knowledge and realistic expectations on the part of the light head injured patient.
The aim of the study was to address the problem of insufficient information
provided to patients suffering from PCS regarding the symptoms they are likely to
suffer. This was done by creating a post-trauma information program consisting
of an attractive and multicoloured booklet with easy access to various issues such
as explanation of terminology, the neurology of concussion, likely symptoms,
prognosis and recovery time. The booklet was complemented with a casette
recording of relevant issues, presented in different voices, with a calming musical
background.
The patients who were selected to participate in the evaluation of the program had
all presented at the 1 Military Hospital over a period of 18 months with firmly
diagnosed PCS based on scores obtained on the Galveston Orientation and
Amnesia Test (GOAT) and the Glasgow Coma Scale (GCS). A total of 81 white,
male subjects were selected. All the subjects complied with certain criteria such
as Afrikaans or English language proficiency, falling within a particular age group
(16 - 35 years) and with no prior neurological or psychiatric disease.
The 81 patients were randomly divided into groups according to the Solomon fourgroup
design. Pre tests were administered to the two experimental groups. The
pre tests consisted of four subscales of the Profile of Mood States (POMS) and four
subscales of the Personal, Home, Social and Formal Relations Questionnaire
(PHSF). The validities and reliabilities of these scales are wel documented. The
four selected POMS subscales were:
Tension-anxiety
Depression-dejection
Anger-hostility
Fatigue-inertia
The four selected PHSF subscales were:
Self-esteem
Self-control
Health
Formal Relations
One experimental and one control group now received the intervention program.