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Al-Khazali HM, Ashina H, Iljazi A, Al-Sayegh Z, Lipton RB, Ashina M, Ashina S, Schytz HW. Psychiatric Sequelae Following Whiplash Injury: A Systematic Review. Front Psychiatry 2022; 13:814079. [PMID: 35530017 PMCID: PMC9072624 DOI: 10.3389/fpsyt.2022.814079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disturbance are reported following whiplash injury. However, the prevalence of these condition varies among studies. In this review, anxiety, depression, PTSD, and sleep disturbance will be referred as psychiatric outcomes. METHODS We performed a systematic literature search on PubMed and Embase (from database inception until March 20, 2021) to identify studies reporting on the relative frequency of these psychiatric outcomes. Three independent investigators screened titles, abstracts and full-texts. Studies including patients with whiplash injury and where the number of patients with whiplash and anxiety, depression, PTSD, or sleep disturbances could be extrapolated, were included. Furthermore, to be included, studies had to defined psychiatric outcomes in accordance with diagnostic criteria [i.e., Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD)] or by use of a validated instrument with cut-off scores for assessing psychiatric symptoms. Quality rating was done using the Newcastle-Ottawa Scale (NOS) on the included studies. A protocol was registered with PROSPERO (CRD42021232037). RESULTS The literature search identified 5,068 citations, of which five articles were eligible for inclusion. The relative frequency of depressive symptoms following whiplash injury was 32.8% at 6 months, and 34.0% at 6-12 months. The relative frequency of PTSD symptoms after whiplash injury was 9.0-22.3% at 3 months, 15.8% at 6 months and 14.6-17.1% at 12 months. No studies evaluating the relative frequency of anxiety and sleep disturbances were eligible for inclusion. DISCUSSION AND CONCLUSION Our results suggest that there are persistent psychiatric outcomes following whiplash trauma. However, we found considerable heterogeneity among the studies. Thus, we have focused on the most notable limitations of the included studies: 1) small sample sizes, 2) differences in enrollment criteria, 3) lack of control groups, 4) considerable variation in the method used for outcome assessment, 5) directionality of association is difficult to determine and 6) incomplete assessment of compensation factors. We highlight these methodological limitations and outline recommendations for future research. Since psychiatric outcomes are potentially modifiable, future studies should optimize and address the identified methodological limitations so psychiatric sequelae following whiplash injury may be prevented.
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Affiliation(s)
- Haidar Muhsen Al-Khazali
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Håkan Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Neurorehabilitation / Traumatic Brain Injury, Rigshospitalet Glostrup, Copenhagen, Denmark
| | - Afrim Iljazi
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Zainab Al-Sayegh
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, United States
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sait Ashina
- BIDMC Comprehensive Headache Center, Departments of Neurology and Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Henrik W Schytz
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Shah P, Attia M, Dillon WA, Sulway S, Ranalli P, Rutka JA, Gerretsen P. Receiving Long-Term Disability or Pursuing a Legal Claim May Prevent Recovery From Chronic Dizziness. Laryngoscope 2021; 132:655-661. [PMID: 34591978 DOI: 10.1002/lary.29871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Chronic dizziness (CD) and imbalance have multiple etiologies. CD is strongly linked with psychiatric and psychological comorbidities, thus an interdisciplinary approach, including psychopharmacological interventions, is recommended. Despite the use of this comprehensive treatment approach, the recovery of individuals with CD that pursue long-term disability (LTD) insurance or legal claims (LC) appears hampered. As such, we aimed to compare symptom recovery from CD in an interdisciplinary setting between patients receiving LTD/LC versus those who were not, and to explore the factors that may contribute to changes in symptom severity. STUDY DESIGN Retrospective cohort study. METHODS Dizziness-related diagnoses were extracted from the charts of 195 adults in an outpatient interdisciplinary neurotology clinic in Toronto, Canada. Patients with baseline Dizziness Handicap Inventory (DHI) and Dizziness Catastrophizing Scale (DCS) assessments between August 2012 and July 2018 and a mean follow-up visit within approximately 10 months were included. The study participants were categorized as "LTD/LC+" (n = 92) or "LTD/LC-" (n = 103), referring to either receiving or pursuing LTD/LC or not, respectively. RESULTS There were differences in the mean percentage changes in DHI (t[187] = 3.02, P = .003) and DCS (t[179] = 2.63, P = .009) scores between LTD/LC+ and LTD/LC- patients. LTD/LC+ patients showed 8.0% and 7.6% mean increases in DHI and DCS scores, respectively, whereas LTD/LC- patients showed 21.5% and 25.9% reductions in DHI and DCS scores, respectively, controlling for age, sex, and baseline illness severity. CONCLUSIONS Patients receiving or pursuing LTD insurance or a legal claim did not improve from CD and dizziness catastrophizing compared to those who were not. Future studies are required to test these findings prospectively and to determine the factors that may contribute to symptom recovery, including the anxiety-aggravating effects of the LTD/LC process and the deleterious consequences of developing a sick-role while afflicted with a chronic illness. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Parita Shah
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Mohamed Attia
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Wanda A Dillon
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Shaleen Sulway
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Paul Ranalli
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John A Rutka
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
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Abd El Fatah SA. Multifarious experiences of women drivers post-car accidents: An urban community experience. WOMENS STUDIES INTERNATIONAL FORUM 2021. [DOI: 10.1016/j.wsif.2021.102449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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4
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Silva Guerrero AV, Setchell J, Maujean A, Sterling M. A Comparison of Perceptions of Reassurance in Patients with Nontraumatic Neck Pain and Whiplash-Associated Disorders in Consultations with Primary Care Practitioners-An Online Survey. PAIN MEDICINE 2020; 21:3377-3386. [PMID: 33036025 DOI: 10.1093/pm/pnaa277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Neck pain remains highly prevalent and costly worldwide. Although reassurance has been recommended as a first line of treatment, specific advice on the best ways to provide reassurance has not been provided due to lack of evidence. Pain symptoms and experiences differ between patients with whiplash-associated disorder (WAD) and those with nontraumatic neck pain (NTNP). The aims of this study were to 1) identify and compare the concerns, fears, and worries of patients with WAD and NTNP; and 2) determine if patients believe their concerns are addressed by primary care providers. METHODS These questions were investigated through an online survey, with a convenience sample of 30 participants with NTNP and 20 with WAD. RESULTS A thematic analysis of survey responses resulted in the following seven themes related to common concerns, and two regarding how well concerns were addressed. Common concerns expressed by both groups shared four themes: 1) further structural damage, 2) psychological distress, 3) concerns about the future, and 4) hardships that eventuate. Theme 5), pain/disability is long term, was specific to WAD. Themes 6), pain is current or reoccurring, and 7), interference with daily life, were specific to NTNP. Regarding how well patient concerns were addressed, two overarching themes were common to both conditions: 1) concerns were addressed, with both groups sharing the subthemes "successful treatment," "reassurance," and "trust"; and 2) concerns were not addressed, where all subthemes were shared with the exception of two unique to NTNP. CONCLUSIONS This detailed comparison provides information about neck pain patients' concerns and fears, while providing health practitioners support for selecting strategies to promote reassurance appropriately for individual patient needs. Our findings from patients' perspectives enhance the understanding for providing reassurance for neck pain as proposed by our analysis.
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Affiliation(s)
| | - Jenny Setchell
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Annick Maujean
- Centre for Applied Health Economics, Menzies Health Institute, School of Medicine, Griffith University, Brisbane/Gold Coast, Australia
| | - Michele Sterling
- Recover Injury Research Centre, The University of Queensland, Brisbane, Australia.,NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Australia
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Giummarra MJ, Murgatroyd D, Tran Y, Adie S, Mittal R, Ponsford J, Cameron P, Gabbe B, Harris IA, Cameron ID. Health and return to work in the first two years following road traffic injury: a comparison of outcomes between compensation claimants in Victoria and New South Wales, Australia. Injury 2020; 51:2199-2208. [PMID: 32680598 DOI: 10.1016/j.injury.2020.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/16/2020] [Accepted: 07/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND People who sustain road traffic injuries often have poor health outcomes. While outcomes are often worse in people with a compensation claim, especially in fault-based schemes versus no-fault schemes, few studies have directly compared outcomes across scheme types. OBJECTIVE To compare health and work outcomes between people who had no compensation claim, a fault-based claim, or "no-fault" transport or workers compensation claim after hospitalisation for a road traffic injury. METHODS Participants aged >=18 years admitted to hospital in New South Wales or Victoria for >24 hours were recruited in two separate prospective cohort studies (N=1,034). People who died or sustained minor or very severe injuries were excluded. Groups included Compulsory Third Party (fault-based, n=128), no-fault Transport Accident Commission (TAC; n=454) and workers compensation claimants (n=73), or no claim (n=226). Outcomes at six, 12- and 24-months post-injury included health [SF-12 Mental Component Score (MCS) and Physical Component Score (PCS)], and return to work for people working pre-injury. Multivariable mixed effects linear and logistic regressions, adjusting for demographic and injury covariates, examined differences in health and work outcomes between claimant groups, with fixed effects of time and random effects of participant ID. RESULTS Health status was better in people with a no-fault TAC claim (MCS: m=50.62, 95%CI:49.62,51.62; PCS: m=40.49, 95%CI:39.46,41.52) or no claim (MCS: m=49.99, 95%CI:49.62,51.62; PCS: m=44.36, 95%CI:43.00,45.72), than people with a workers compensation (MCS: m=45.73, 95%CI:43.46,48.00; PCS: m=38.94, 95%CI:36.59,41.30) or fault-based CTP claim (MCS: m=41.34, 95%CI:39.54,43.13; PCS: m=35.64, 95%CI:33.78,37.49). Relative to fault-based CTP claimants, the odds of returning to work were higher for people with no claim (AOR=6.84, 95%CI:1.73,27.05) but did not differ for no-fault TAC (AOR=1.21, 95%CI:0.36,4.05) or workers compensation claimants (AOR=0.83,95%CI: 0.17,3.99). While people with a fault-based CTP claim had poorer mental and physical health and return to work after injury, they showed greater improvements in mental health, and similar levels of improvement in physical health and work participation over time to the other groups. CONCLUSION The patterns of health and work across scheme types provide important insights against which we can contrast the effects of future scheme designs on client outcomes.
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.
| | - Darnel Murgatroyd
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney.
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney; Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University.
| | - Sam Adie
- South West Sydney Clinical School, University of New South Wales, Australia.
| | - Rajat Mittal
- South West Sydney Clinical School, University of New South Wales, Australia.
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Clayton Victoria, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia.
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Belinda Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Health Data Research UK, Swansea University Medical School, Singleton Park, Swansea University, Swansea, Wales, UK SA2 8PP.
| | - Ian A Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney.
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney.
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Lau G, Gabbe BJ, Collie A, Ponsford J, Ameratunga S, Cameron PA, Harrison JE, Giummarra MJ. The Association Between Fault Attribution and Work Participation After Road Traffic Injury: A Registry-Based Observational Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:235-254. [PMID: 31820220 DOI: 10.1007/s10926-019-09867-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose To characterise associations between fault attribution and work participation and capacity after road traffic injury. Methods People aged 15-65 years, working pre-injury, without serious brain injury, who survived to 12 months after road traffic injury were included from two Victorian trauma registries (n = 2942). Fault profiles from linked compensation claims were defined as no other at fault, another at fault, denied another at fault, claimed another at fault, and unknown. Claimant reports in the denied and claimed another at fault groups contradicted police reports. Patients reported work capacity (Glasgow outcome scale-extended) and return to work (RTW) at 6, 12 and 24 months post-injury (early and sustained RTW, delayed RTW (≥ 12 months), failed RTW attempts, no RTW attempts). Analyses adjusted for demographic, clinical and injury covariates. Results The risk of not returning to work was higher if another was at fault [adjusted relative risk ratio (aRRR) = 1.67, 95% confidence interval (CI) 1.29, 2.17] or was claimed to be at fault (aRRR = 1.58, 95% CI 1.04, 2.41), and lower for those who denied that another was at fault (aRRR = 0.51, 95% CI 0.29, 0.91), compared to cases with no other at fault. Similarly, people had higher odds of work capacity limitations if another was at fault (12m: AOR = 1.49, 95% CI 1.24, 1.80; 24m: 1.63, 95% CI 1.35, 1.97) or was claimed to be at fault (12m: AOR = 1.54, 95% CI 1.16, 2.05; 24m: AOR = 1.80, 95% CI 1.34, 2.41), and lower odds if they denied another was at fault (6m: AOR = 0.67, 95% CI 0.48, 0.95), compared to cases with no other at fault. Conclusion Targeted interventions are needed to support work participation in people at risk of poor RTW post-injury. While interventions targeting fault and justice-related attributions are currently lacking, these may be beneficial for people who believe that another caused their injury.
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Affiliation(s)
- Georgina Lau
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, Swansea, Wales, SA2 8PP, UK
| | - Alex Collie
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, VIC, Australia
| | - Shanthi Ameratunga
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Peter A Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - James E Harrison
- Research Centre for Injury Studies, Flinders University, Adelaide, SA, Australia
| | - Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
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Using New Methods of Communication to Improve Outcomes in Workers' Compensation Case Management. Prof Case Manag 2020; 25:179-183. [PMID: 32235202 DOI: 10.1097/ncm.0000000000000436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Samoborec S, Ayton D, Ruseckaite R, Evans SM. Biopsychosocial barriers affecting recovery after a minor transport-related injury: A qualitative study from Victoria. Health Expect 2019; 22:1003-1012. [PMID: 31155834 PMCID: PMC6803416 DOI: 10.1111/hex.12907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of the study was to understand the recovery phenomena and to explore participants' perspectives on the biopsychosocial facilitators and barriers affecting their recovery after a minor transport injury. Methods A qualitative method was used involving semi‐structured interviews with 23 participants who sustained a minor transport injury. Interviews and analysis were guided by the biopsychosocial model (BPS) of health. The outcomes were themes capturing biopsychosocial barriers to, and personal experiences of, recovery using a previously defined framework. Results The themes indicate that recovery is a multifaceted phenomenon affected by comorbidities such as chronic pain, depression and anxiety. A range of subsequent complexities such as the inability to self‐care and undertaking daily domestic duties, and incapacity to participate in recreational activities were major barriers to recovery. These barriers were found to be an on‐going source of frustration, dissatisfaction and a perceived cause of depressive symptomatology in many participants. Most participants reported mixed feelings of the care received. Other common issues raised included a lack of understanding of the assessment time, regular follow‐up, guidance and on‐going support. Conclusion This study revealed that recovery after a minor transport‐related injury was a challenging, complex, demanding and a long‐term process for the individuals in this study. Findings from this limited cohort suggested that, for participants to return to their pre‐accident health status, a more coordinated approach to information and care delivery may be required.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susan M Evans
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Baker E, Xyrichis A, Norton C, Hopkins P, Lee G. The long-term outcomes and health-related quality of life of patients following blunt thoracic injury: a narrative literature review. Scand J Trauma Resusc Emerg Med 2018; 26:67. [PMID: 30119640 PMCID: PMC6098638 DOI: 10.1186/s13049-018-0535-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major Trauma remains a leading cause of mortality and morbidity worldwide. Blunt Thoracic Injury (BTI) accounts for > 15% of United Kingdom (UK) trauma admissions and is consistently associated with respiratory related complications that include pneumonia and respiratory failure. Despite this, it is unclear in current clinical practice how BTI impacts on the recovering trauma patients after discharge from hospital. This study aimed to investigate the state of knowledge on the impact of BTI on the long-term outcomes and health-related quality of life (HRQoL). METHODS Data were sourced from Ovid MEDLINE, Ovid EMBASE, CINAHL and Science Direct using a pre-defined systematic search strategy. A subsequent hand search of key references was used to identify potentially missed studies. Abstracts were screened for eligibility and inclusion. Fifteen studies met the eligibility criteria and were critically appraised. Data were extracted, analysed and synthesised in categories and sub-categories following a narrative approach. RESULTS Three major themes were identified from the 15 studies included in this review: (i) physical impact of BTI, (ii) psychological impact of BTI and (iii) socio-economic impact of BTI. The bulk of the available data focused on the physical impact where further sub-themes included: (i) physical functioning, (ii) ongoing unresolved pain, (iii) reduced respiratory function, (iv) thoracic structural integrity. Although there was a substantial difference in the length and method of follow up, there remains a general trend towards physical symptoms improving over time, particularly over the first six months after injury. Despite this, where sequelae continued at six months it remained likely that these would also be present at two years after injury. CONCLUSION The literature review demonstrated that BTI is associated with substantial sequelae that impacts on all aspects of daily functioning. Despite this there remains a paucity of data relating to long term outcomes in the BTI population, especially relating to psychological and socio-economic impact. There is also little consensus on the measures, tools and time-frames used to measure outcomes and HRQoL in this population. The full impact of BTI on this population needs further exploration.
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Affiliation(s)
- Edward Baker
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK. .,Emergency Department, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
| | - Andreas Xyrichis
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
| | - Philip Hopkins
- Department of Intensive Care Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
| | - Geraldine Lee
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK
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10
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Samoborec S, Ruseckaite R, Ayton D, Evans S. Biopsychosocial factors associated with non-recovery after a minor transport-related injury: A systematic review. PLoS One 2018; 13:e0198352. [PMID: 29894490 PMCID: PMC5997362 DOI: 10.1371/journal.pone.0198352] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/17/2018] [Indexed: 11/29/2022] Open
Abstract
Background Globally, road transport accidents contribute significantly to mortality and burden of disability. Up to 50 million people suffer a transport-related non-fatal injury each year, which often leads to long-term disability. A substantial number of people with minor injuries struggle to recover and little is known about the factors leading to poor or non-recovery. The aim of this paper is to present a systematic review of biopsychosocial factors related to poor or non-recovery after a minor transport-related injury. Methods and findings Studies were selected through searches of PubMed, Medline, Embase, and Cochrane library. Methodological quality was assessed using a Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklist for quantitative cohort studies and Standards for Reporting Qualitative Research (SRQR) checklist for qualitative articles. Data were extracted using the Cochrane data extraction tool based on the biopsychosocial model of health (BPS). In total, there were 37 articles included. However, heterogeneity of the techniques and tools used to assess factors and outcomes across studies meant that pooling of results to determine biopsychosocial factors most predictive of poor or non-recovery was not possible. Hence, a narrative synthesis was conducted and shown multiple factors to be associated with poorer outcomes or non-recovery, most being identified in the biological and psychological domain of the BPS model. Factors that were the most representative across studies and have shown to have the strongest associations with poor or non-recovery were high initial pain intensity, pain duration and severity, pre-accident physical and mental health status and pain catastrophising. Conclusions This review demonstrates the complexity of recovery and a challenge in reporting on predictors of recovery. It is evident that a range of multi-factorial biopsychosocial factors impact recovery. These factors are often inter-connected and multi-faceted and therefore, it was not feasible to select or focus on one single factor. In defining the most predictive factors, further research is required, yet the consensus around which tools to use to measure recovery outcomes is needed and is highly recommended. Regardless of the descriptive nature, the review demonstrated that high levels of post-injury pain are associated with poorer outcomes such as chronic pain and physical and mental disability. Therefore, early targeting of modifiable factors such as pain, pain catastrophizing and arising comorbidities such as PTSD, depression and anxiety may assist in reducing chronic pain and ongoing related disabilities. Systematic review trial registration number Systematic review protocol was registered in International Prospective Register for Systematic Reviews (PROSPERO) on 14 December 2016. Registration number CRD42016052276.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
- * E-mail:
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
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The Impact of Psychosocial and Contextual Factors on Individuals Who Sustain Whiplash-Associated Disorders in Motor Vehicle Collisions. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9317-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Financial and recovery worry one year after traumatic injury: A prognostic, registry-based cohort study. Injury 2018; 49:990-1000. [PMID: 29653676 DOI: 10.1016/j.injury.2018.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Levels of stress post-injury, especially after compensable injury, are known to be associated with worse long-term recovery. It is therefore important to identify how, and in whom, worry and stress manifest post-injury. This study aimed to identify demographic, injury, and compensation factors associated with worry about financial and recovery outcomes 12 months after traumatic injury. METHODS Participants (n = 433) were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry after admission to a major trauma hospital in Melbourne, Australia. Participants completed questionnaires about pain, compensation experience and psychological wellbeing as part of a registry-based observational study. RESULTS Linear regressions showed that demographic and injury factors accounted for 11% and 13% of variance in financial and recovery worry, respectively. Specifically, lower education, discharge to inpatient rehabilitation, attributing fault to another and having a compensation claim predicted financial worry. Worry about recovery was only predicted by longer hospital stay and attributing fault to another. In all participants, financial and recovery worry were associated with worse pain (severity, interference, catastrophizing, kinesiophobia, self-efficacy), physical (disability, functioning) and psychological (anxiety, depression, PTSD, perceived injustice) outcomes 12 months post-injury. In participants who had transport (n = 135) or work (n = 22) injury compensation claims, both financial and recovery worry were associated with sustaining permanent impairments, and reporting negative compensation system experience 12 months post-injury. Financial worry 12 months post-injury was associated with not returning to work by 3-6 months post-injury, whereas recovery worry was associated with attributing fault to another, and higher healthcare use at 6-12 months post-injury. CONCLUSIONS These findings highlight the important contribution of factors other than injury severity, to worry about finances and recovery post-injury. Having a compensation claim, failure to return to work and experiencing pain and psychological symptoms also contribute to elevated worry. As these factors explained less than half of the variance in worry, however, other factors not measured in this study must play a role. As worry may increase the risk of developing secondary mental health conditions, timely access to financial, rehabilitation and psychological supports should be provided to people who are not coping after injury.
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Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:1255-1261. [DOI: 10.1007/s00586-018-5507-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
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Chronic Pain Following Motor Vehicle Collision: A Systematic Review of Outcomes Associated With Seeking or Receiving Compensation. Clin J Pain 2017; 32:817-27. [PMID: 26889614 DOI: 10.1097/ajp.0000000000000342] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Motor vehicle collisions (MVC) are a major cause of injury, which frequently lead to chronic pain and prolonged disability. Several studies have found that seeking or receiving financial compensation following MVC leads to poorer recovery and worse pain. We evaluated the evidence for the relationship between compensation and chronic pain following MVC within a biopsychosocial framework. METHOD A comprehensive search of 5 computerized databases was conducted. Methodological quality was evaluated independently by 2 researchers according to formal criteria, and discrepancies were resolved with a third reviewer. RESULTS We identified 5619 studies, from which 230 full-text articles were retrieved and 27 studies were retained for appraisal. A third of studies (37%) were of low quality, and 44% did not measure or control for factors such as injury severity or preinjury pain and disability. Most studies (70%) reported adverse outcomes, including all of the highest quality studies. Engagement with compensation systems was related to more prevalent self-reported chronic pain, mental health disorders, and reduced return to work. Recovery was poorer when fault was attributed to another, or when a lawyer was involved. Five studies compared Tort "common law" and No-Fault schemes directly and concluded that Tort claimants had poorer recovery. CONCLUSIONS Although causal relationships cannot be assumed, the findings imply that aspects of loss, injustice, and secondary mental health outcomes lead to chronic pain following MVC. Further robust prospective research is required to understand the complex relationship between compensation systems and pain following road trauma, particularly the role of secondary mental health outcomes.
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Traumatic injury and perceived injustice: Fault attributions matter in a "no-fault" compensation state. PLoS One 2017; 12:e0178894. [PMID: 28582459 PMCID: PMC5459431 DOI: 10.1371/journal.pone.0178894] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/19/2017] [Indexed: 12/01/2022] Open
Abstract
Background Traumatic injury can lead to loss, suffering and feelings of injustice. Previous research has shown that perceived injustice is associated with poorer physical and mental wellbeing in persons with chronic pain. This study aimed to identify the relative association between injury, compensation and pain-related characteristics and perceived injustice 12-months after traumatic injury. Methods 433 participants were recruited from the Victorian Orthopedic Trauma Outcomes Registry and Victorian State Trauma Registry, and completed questionnaires at 12–14 months after injury as part of an observational cohort study. Using hierarchical linear regression we examined the relationships between baseline demographics (sex, age, education, comorbidities), injury (injury severity, hospital length of stay), compensation (compensation status, fault, lawyer involvement), and health outcomes (SF-12) and perceived injustice. We then examined how much additional variance in perceived injustice was related to worse pain severity, interference, self-efficacy, catastrophizing, kinesiophobia or disability. Results Only a small portion of variance in perceived injustice was related to baseline demographics (especially education level), and injury severity. Attribution of fault to another, consulting a lawyer, health-related quality of life, disability and the severity of pain-related cognitions explained the majority of variance in perceived injustice. While univariate analyses showed that compensable injury led to higher perceptions of injustice, this did not remain significant when adjusting for all other factors, including fault attribution and consulting a lawyer. Conclusions In addition to the “justice” aspects of traumatic injury, the health impacts of injury, emotional distress related to pain (catastrophizing), and the perceived impact of pain on activity (pain self-efficacy), had stronger associations with perceptions of injustice than either injury or pain severity. To attenuate the likelihood of poor recovery from injury, clinical interventions that support restoration of health-related quality of life, and adjustment to the impacts of trauma are needed.
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Giummarra MJ, Cameron PA, Ponsford J, Ioannou L, Gibson SJ, Jennings PA, Georgiou-Karistianis N. Return to Work After Traumatic Injury: Increased Work-Related Disability in Injured Persons Receiving Financial Compensation is Mediated by Perceived Injustice. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:173-185. [PMID: 27150733 DOI: 10.1007/s10926-016-9642-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose Traumatic injury is a leading cause of work disability. Receiving compensation post-injury has been consistently found to be associated with poorer return to work. This study investigated whether the relationship between receiving compensation and return to work was associated with elevated symptoms of psychological distress (i.e., anxiety, depression, and posttraumatic stress disorder) and perceived injustice. Methods Injured persons, who were employed at the time of injury (n = 364), were recruited from the Victorian State Trauma Registry, and Victorian Orthopaedic Trauma Outcomes Registry. Participants completed the Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist, Injustice Experience Questionnaire, and appraisals of pain and work status 12-months following traumatic injury. Results Greater financial worry and indicators of actual/perceived injustice (e.g., consulting a lawyer, attributing fault to another, perceived injustice, sustaining compensable injury), trauma severity (e.g., days in hospital and intensive care, discharge to rehabilitation), and distress symptoms (i.e., anxiety, depression, PTSD) led to a twofold to sevenfold increase in the risk of failing to return to work. Anxiety, post-traumatic stress and perceived injustice were elevated following compensable injury compared with non-compensable injury. Perceived injustice uniquely mediated the association between compensation and return to work after adjusting for age at injury, trauma severity (length of hospital, admission to intensive, and discharge location) and pain severity. Conclusions Given that perceived injustice is associated with poor return to work after compensable injury, we recommend greater attention be given to appropriately addressing psychological distress and perceived injustice in injured workers to facilitate a smoother transition of return to work.
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Affiliation(s)
- Melita J Giummarra
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia.
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
- School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3000, Australia.
| | - Peter A Cameron
- School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3000, Australia
- Emergency Department, Hamad General Hospital, Doha, Qatar
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, VIC, Australia
| | - Liane Ioannou
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Stephen J Gibson
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia
- National Ageing Research Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Paul A Jennings
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia
- College of Health and Biomedicine, Victoria University, Footscray, VIC, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
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Guest R, Tran Y, Gopinath B, Cameron ID, Craig A. Psychological distress following a motor vehicle crash: A systematic review of preventative interventions. Injury 2016; 47:2415-2423. [PMID: 27616005 DOI: 10.1016/j.injury.2016.09.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/05/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Psychological distress following a motor vehicle crash (MVC) is prevalent, especially when the person sustains an associated physical injury. Psychological distress can exhibit as elevated anxiety and depressive mood, as well as presenting as mental disorders such as Post Traumatic Stress Disorder (PTSD) or Major Depressive Disorder (MDD). If unmanaged, psychological distress can contribute to, or exacerbate negative outcomes such as social disengagement (e.g., loss of employment) and poor health-related quality of life, as well as contribute to higher costs to insurers. This systematic review summarises current research concerning early psychological intervention strategies aimed at preventing elevated psychological distress occurring following a MVC. METHOD A systematic review of psychological preventative intervention studies was performed. Searches of Medline, Embase, PsychINFO, Web of Science and Cochrane Library were used to locate relevant studies published between 1985 and September 2015. Included studies were those investigating MVC survivors who had received an early psychological intervention aimed at preventing psychological distress, and which had employed pre- and post- measures of constructs such as depression, anxiety and disorders such as PTSD. RESULTS Searches resulted in 2608 records. Only six studies investigated a psychological preventative intervention post-MVC. Interventions such as injury health education, physical activity and health promotion, and therapist-assisted problem solving did not result in significant treatment effects. Another six studies investigated psychological interventions given to MVC survivors who were assessed as sub-clinically psychologically distressed prior to their randomisation. Efficacy was varied, however three studies employing cognitive behaviour therapy (CBT) found significant reductions in psychological distress compared to wait-list controls. CONCLUSION Psychological interventions aimed at preventing psychological distress post-MVC are limited, often involving small samples, with subsequent poor statistical power and subsequent high risk of bias. These factors make it difficult to draw conclusions, however CBT appears encouraging and therefore worthy of consideration as a preventative intervention.
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Affiliation(s)
- Rebecca Guest
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Australia.
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Australia
| | - Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Australia
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Compensation System Experience at 12 Months After Road or Workplace Injury in Victoria, Australia. PSYCHOLOGICAL INJURY & LAW 2016. [DOI: 10.1007/s12207-016-9275-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Goodman-Delahunty J, Schuller R, Martschuk N. Workplace Sexual Harassment in Policing: Perceived Psychological Injuries by Source and Severity. PSYCHOLOGICAL INJURY & LAW 2016. [DOI: 10.1007/s12207-016-9265-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Elbers NA, Collie A, Hogg-Johnson S, Lippel K, Lockwood K, Cameron ID. Differences in perceived fairness and health outcomes in two injury compensation systems: a comparative study. BMC Public Health 2016; 16:658. [PMID: 27473747 PMCID: PMC4966779 DOI: 10.1186/s12889-016-3331-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/21/2016] [Indexed: 12/04/2022] Open
Abstract
Background Involvement in a compensation process following a motor vehicle collision is consistently associated with worse health status but the reasons underlying this are unclear. Some compensation systems are hypothesised to be more stressful than others. In particular, fault-based compensation systems are considered to be more adversarial than no-fault systems and associated with poorer recovery. This study compares the perceived fairness and recovery of claimants in the fault-based compensation system in New South Wales (NSW) to the no-fault system in Victoria, Australia. Methods One hundred eighty two participants were recruited via claims databases of the compensation system regulators in Victoria and NSW. Participants were > 18 years old and involved in a transport injury compensation process. The crash occurred 12 months (n = 95) or 24 months ago (n = 87). Perceived fairness about the compensation process was measured by items derived from a validated organisational justice questionnaire. Health outcome was measured by the initial question of the Short Form Health Survey. Results In Victoria, 84 % of the participants considered the claims process fair, compared to 46 % of NSW participants (χ2 = 28.54; p < .001). Lawyer involvement and medical assessments were significantly associated with poorer perceived fairness. Overall perceived fairness was positively associated with health outcome after adjusting for demographic and injury variables (Adjusted Odds Ratio = 2.8, 95 % CI = 1.4 – 5.7, p = .004). Conclusion The study shows large differences in perceived fairness between two different compensation systems and an association between fairness and health. These findings are politically important because compensation processes are designed to improve recovery. Lower perceived fairness in NSW may have been caused by potential adversarial aspects of the scheme, such as liability assessment, medical assessments, dealing with a third party for-profit insurance agency, or financial insecurity due to lump sum payments at settlement. This study should encourage an evidence informed discussion about how to reduce anti-therapeutic aspects in the compensation process in order to improve the injured person’s health.
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Affiliation(s)
- Nieke A Elbers
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Sydney, Australia.
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia
| | | | | | - Keri Lockwood
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, University of Sydney, Sydney, Australia
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Tournier C, Hours M, Charnay P, Chossegros L, Tardy H. Five years after the accident, whiplash casualties still have poorer quality of life in the physical domain than other mildly injured casualties: analysis of the ESPARR cohort. BMC Public Health 2016; 16:13. [PMID: 26733122 PMCID: PMC4702400 DOI: 10.1186/s12889-015-2647-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/18/2015] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to compare health status and quality of life five years after a road accident between casualties with whiplash versus other mild injuries, to compare evolution of quality of life at 1 and 5 years after the accident, and to explore the relation between initial injury (whiplash vs. other) and quality of life. Methods The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 167 casualties with “pure” whiplash and a population of 185 casualties with other mild injuries (MAIS-1). All subjects with lesions classified as cervical contusion (AIS code 310402) or neck sprain (AIS code 640278) were considered as whiplash casualties. Diagnosis was made by physicians, at the outset of hospital care, based on interview, clinical findings and X-ray. Whiplash injuries were then classified following the Quebec classification (grades 1 and 2). Quality of life was assessed on the WHOQoL-Bref questionnaire. Correlations between explanatory variables and quality of life were explored by Poisson regression and variance analysis. Results Between 1 and 5 years, global QoL improved for both whiplash and non-whiplash casualties; but, considering the two whiplash groups separately, improvement in grade 2 was much less than in grade 1. At 5 years, grade-2 whiplash casualties were more dissatisfied with their health (39.4 %; p < 0.05) than non-whiplash (24.3 %) or grade-1 whiplash casualties (27.0 %). Deteriorated quality of life in the mental, social and environmental domains was mainly related to psychological and socioeconomic factors for both whiplash and other mildly injured road-accident casualties. While PTSD was a major factor for the physical domain, whiplash remained a predictive factor after adjustment on PTSD; unsatisfactory health at 5 years, with deteriorated quality of life in the physical domain, was observed specifically in the whiplash group, pain playing a predominant intermediate role. Conclusions Deteriorated quality of life in the physical domain remained 5 years after the accident, specifically in the grade-2 whiplash group, pain playing a predominant intermediate role, which may be in line with the hypothesis of neuropathic pain.
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Affiliation(s)
- Charlène Tournier
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T 9405), Université Lyon 1, Université de Lyon, Lyon, France
| | - Martine Hours
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T 9405), Université Lyon 1, Université de Lyon, Lyon, France.
| | - Pierrette Charnay
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T 9405), Université Lyon 1, Université de Lyon, Lyon, France
| | - Laetitia Chossegros
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T 9405), Université Lyon 1, Université de Lyon, Lyon, France
| | - Hélène Tardy
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T 9405), Université Lyon 1, Université de Lyon, Lyon, France
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Kilgour E, Kosny A, Akkermans A, Collie A. Procedural Justice and the Use of Independent Medical Evaluations in Workers’ Compensation. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9222-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Associations with legal representation in a compensation setting 12 months after injury. Injury 2015; 46:918-25. [PMID: 25613701 DOI: 10.1016/j.injury.2015.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/24/2014] [Accepted: 01/01/2015] [Indexed: 02/02/2023]
Abstract
CONTEXT Many people with Whiplash Associated Disorder (WAD) seek treatment though a compensation system where factors such as legal involvement have been reported as having a negative impact on recovery outcomes. OBJECTIVE To compare those with and without legal involvement in their compensation claim, and identify associations with legal involvement at 12 months post injury; and longer term disability. STUDY DESIGN Inception cohort study. PARTICIPANTS 246 people with WAD compensation claim. OUTCOME MEASURES Legal involvement and Functional Rating Index at 12 months post injury. METHODS Participants were recruited from an insurance database. Baseline health (Functional Rating Index, Pain Catastrophising Scale and SF-36), socio-economic, work capacity, and claims data were collected within three months of injury and 12 months. Logistic regression models were used to identify associations with legal involvement at 12 months; and disability (FRI) at 12 months. RESULTS At baseline 246 participants were enrolled into the study in a median 72 days post injury. At 12 months post injury 52 (25%) had engaged a lawyer. The significant independent associations with legal involvement at 12 months were higher levels of initial disability, work disability, speaking a language other than English at home and lower levels of mental health. Specifically, the odds of lawyer involvement at 12 months post injury was 4.9 times greater for those with work disability; 2.3 times greater for those who spoke a language other than English at home. In terms of health, they had poorer mental health and for every 10 unit increase in the baseline FRI score the odds of having lawyer involvement increased by 38%. DISABILITY: at 12 months (FRI) was significantly independently associated with, PCS-helplessness (p<0.001), age (p<0.001) and prior claim (p=0.001). CONCLUSION This study suggests the people with lawyer involvement in their claim 12 months after injury have socio-economic disadvantage, have had a prior claim and a worse baseline health profile compared to those without a lawyer. Understanding this profile could allow for improved claims processes and targeted interventions to assist this group through any perceived complexities in the system and address the underlying reasons for lawyer participation within compensation schemes.
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van der Meer S, Pieterse M, Reneman M, Verhoeven J, van der Palen J. How does injury compensation affect health and disability in patients with complaints of whiplash? A qualitative study among rehabilitation experts-professionals. Disabil Rehabil 2015; 38:211-7. [DOI: 10.3109/09638288.2015.1035455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Elbers NA, Akkermans AJ, Cuijpers P, Bruinvels DJ. Effectiveness of a web-based intervention for injured claimants: a randomized controlled trial. Trials 2013; 14:227. [PMID: 23870540 PMCID: PMC3722043 DOI: 10.1186/1745-6215-14-227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 07/09/2013] [Indexed: 04/12/2023] Open
Abstract
Background There is considerable evidence showing that injured people who are involved in a compensation process show poorer physical and mental recovery than those with similar injuries who are not involved in a compensation process. One explanation for this reduced recovery is that the legal process and the associated retraumatization are very stressful for the claimant. The aim of this study was to empower injured claimants in order to facilitate recovery. Methods Participants were recruited by three Dutch claims settlement offices. The participants had all been injured in a traffic crash and were involved in a compensation process. The study design was a randomized controlled trial. An intervention website was developed with (1) information about the compensation process, and (2) an evidence-based, therapist-assisted problem-solving course. The control website contained a few links to already existing websites. Outcome measures were empowerment, self-efficacy, health status (including depression, anxiety, and somatic symptoms), perceived fairness, ability to work, claims knowledge and extent of burden. The outcomes were self-reported through online questionnaires and were measured four times: at baseline, and at 3, 6, and 12 months. Results In total, 176 participants completed the baseline questionnaire after which they were randomized into either the intervention group (n = 88) or the control group (n = 88). During the study, 35 participants (20%) dropped out. The intervention website was used by 55 participants (63%). The health outcomes of the intervention group were no different to those of the control group. However, the intervention group considered the received compensation to be fairer (P <0.01). The subgroup analysis of intervention users versus nonusers did not reveal significant results. The intervention website was evaluated positively. Conclusions Although the web-based intervention was not used enough to improve the health of injured claimants in compensation processes, it increased the perceived fairness of the compensation amount. Trial registration Netherlands Trial Register NTR2360
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