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Clin J Pain. 2015 Jan;31(1):14-20. doi: 10.1097/AJP.0000000000000085.

The role of illness perceptions in predicting outcome after acute whiplash trauma: a multicenter 12-month follow-up study.

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1
*The Research Clinic for Functional Disorders and Psychosomatics †Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

Abstract

OBJECTIVES:

To examine (1) whether the patients' perceptions of their symptoms immediately after the accident and at 3-month follow-up predict working ability and neck pain at 12-month follow-up and (2) the possible changes in patients' illness perceptions during the follow-up period.

MATERIALS AND METHODS:

A total of 740 consecutive patients exposed to acute whiplash trauma consulting emergency units and general practitioners in 4 Danish counties from 2001 to 2003. The patients completed questionnaires at baseline, 3-, and 12-month follow-up. Illness perceptions were measured using a condensed version of the Illness Perception Questionnaire and a 1-item question concerning return to work expectation. Neck pain was measured using an 11-point box scale, and working ability was measured by self-report at 12-month follow-up. Multiple logistic regression analyses were applied controlling for possible confounders.

RESULTS:

Patients with pessimistic illness perceptions at baseline and 3-month follow-up were more likely to experience neck pain and affected working ability at 12 months compared with patients with optimistic illness perceptions. Negative return-to-work expectation predicted affected working ability at 12 months. Furthermore, patients with high neck pain intensity or affected working ability report more changes in their illness perceptions during follow-up than patients with low neck pain intensity or unaffected working ability.

DISCUSSION:

The findings are in line with the common-sense model of illness and previous research demonstrating that patient's expectations for recovery and illness perceptions might influence the course after whiplash injury. Illness perceptions and expectations may provide a useful starting point for future interventions and be targeted in the prevention of chronicity.

PMID:
25084071
DOI:
10.1097/AJP.0000000000000085
[Indexed for MEDLINE]

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