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Yamashita Y, Kogo H, Inoue T, Higashi T. Predictors of Delayed Recovery in Japanese Patients With Whiplash-Associated Disorders: The Role of Initial Catastrophizing and Disability Levels. Cureus 2024; 16:e66435. [PMID: 39247018 PMCID: PMC11380373 DOI: 10.7759/cureus.66435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/10/2024] Open
Abstract
Background Whiplash-associated disorders are sequelae of traffic accidents that frequently result in sustained pain and disability due to a broader spectrum of symptoms than typical neck pain. Several studies have used the length of time from injury to the completion of insurance claims as a measure of recovery time for patients with whiplash-associated disorders. However, studies on the initial factors in patients whose treatment exceeds 90 days are lacking. Therefore, this study aimed to identify key factors predicting prolonged treatment duration in Japanese patients with whiplash-associated disorders. Methodology We included 103 outpatients who presented with neck pain after a motor vehicle accident. During their initial visits, various factors were comprehensively assessed, including pain intensity, Neck Disability Index (NDI), six items of the Pain Catastrophizing Scale (PCS-6), a short version of the Tampa Scale of Kinesiophobia, the Injustice Experience Questionnaire, cervical range of motion, and radiographic findings. Patients were categorized into "early recovery" or "delayed recovery" groups based on the time elapsed between the first assessment and the end of the treatment period. Logistic regression analysis identified cut-off values from receiver operating characteristic curves to help identify factors contributing to delays in the recovery process. Results Analysis showed that initial NDI and PCS-6 scores of ≥35% and ≥12, respectively, were significant predictors of delayed recovery, increasing the odds of delay by factors of 3.19 and 4.46, respectively. Conclusions Our findings may aid in appropriate clinical decision-making and lead to interventions to minimize the negative impact of prolonged treatment duration on patient recovery.
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Affiliation(s)
- Yuh Yamashita
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
- Department of Rehabilitation, Morinaga Orthopedic Clinic, Saga, JPN
| | - Haruki Kogo
- Faculty of Rehabilitation Sciences, Reiwa Health Sciences University, Fukuoka, JPN
| | - Tadatoshi Inoue
- Department of Rehabilitation Major in Occupational Therapy, Heisei College of Health Sciences, Gifu, JPN
| | - Toshio Higashi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
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2
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Gopinath B, Jagnoor J, Kifley A, Pozzato I, Craig A, Cameron ID. Health literacy and recovery following a non-catastrophic road traffic injury. BMC Public Health 2022; 22:1380. [PMID: 35854243 PMCID: PMC9295516 DOI: 10.1186/s12889-022-13707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background Health literacy (HL) is rarely addressed in rehabilitation research and practice but can play a substantial role in the recovery process after an injury. We aimed to identify factors associated with low HL and its relationship with 6-month health outcomes in individuals recovering from a non-catastrophic road traffic injury. Methods Four hundred ninety-three participants aged ≥17 years who had sustained a non-catastrophic injury in a land-transport crash, underwent a telephone-administered questionnaire. Information was obtained on socio-economic, pre-injury health and crash-related characteristics, and health outcomes (quality of life, pain related measures and psychological indices). Low HL was defined as scoring < 4 on either of the two scales of the Health Literacy Questionnaire that covered: ability to actively engage with healthcare providers (‘Engagement’ scale); and/or understanding health information well enough to know what to do (‘Understanding’ scale). Results Of the 493, 16.9 and 18.7% scored < 4 on the ‘Understanding’ and ‘Engagement’ scale (i.e. had low HL), respectively. Factors that were associated with low HL as assessed by both scales were: having pre-injury disability and psychological conditions; lodging a third-party insurance claim; experiencing overwhelming/great perceived sense of danger/death during the crash; type of road user; low levels of social satisfaction; higher pain severity; pain catastrophizing; and psychological- and trauma-related distress. Low HL (assessed by both scales) was associated with poorer recovery outcomes over 6 months. In these longitudinal analyses, the strongest association was with disability (p < 0.0001), and other significant associations were higher levels of catastrophizing (p = 0.01), pain severity (p = 0.04), psychological- (p ≤ 0.02) and trauma-related distress (p = 0.003), lower quality of life (p ≤ 0.03) and physical functioning (p ≤ 0.01). Conclusions A wide spectrum of factors including claim status, pre-injury and psychological measures were associated with low HL in injured individuals. Our findings suggest that targeting low HL could help improve recovery outcomes after non-catastrophic injury.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia. .,Macquarie University Hearing, Department of Linguistics, Faculty of Medicine, Health and Human Sciences, The Australian Hearing Hub, 16 University Avenue, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Annette Kifley
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ilaria Pozzato
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
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Nguyen TL, Baker KS, Ioannou L, Hassani-Mahmooei B, Gibson SJ, Collie A, Ponsford J, Cameron PA, Gabbe BJ, Giummarra MJ. Prognostic Role of Demographic, Injury and Claim Factors in Disabling Pain and Mental Health Conditions 12 Months after Compensable Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7320. [PMID: 33036417 PMCID: PMC7579145 DOI: 10.3390/ijerph17197320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3-6 months post-injury, persistent work disability and opioid use at 6-12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3-6 months, work disability and psychotropic medications at 6-12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed.
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Affiliation(s)
- Thi L. Nguyen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Katharine S. Baker
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, 27 Rainforest Walk, Clayton, VIC 3800, Australia; (K.S.B.); (J.P.)
| | - Liane Ioannou
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Behrooz Hassani-Mahmooei
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Stephen J. Gibson
- Caulfield Pain Management and Research Centre, Caulfield Hospital, 260–294 Kooyong Rd, Caulfield, VIC 3162, Australia;
| | - Alex Collie
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, 27 Rainforest Walk, Clayton, VIC 3800, Australia; (K.S.B.); (J.P.)
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, 89 Bridge Rd, Richmond, VIC 3121, Australia
| | - Peter A. Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
| | - Belinda J. Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
- Health Data Research UK, Swansea University Medical School, Swansea University, Wales, Sketty, Swansea SA2 8QA, UK
| | - Melita J. Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton, VIC 3800, Australia; (T.L.N.); (L.I.); (B.H.-M.); (A.C.); (P.A.C.); (B.J.G.)
- Caulfield Pain Management and Research Centre, Caulfield Hospital, 260–294 Kooyong Rd, Caulfield, VIC 3162, Australia;
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Brown K, Cameron ID, Keay L, Rogers K, Nguyen H, Vines P, Ivers R. Factors influencing duration of compensation following road traffic crash injury in older vs younger adults. Australas J Ageing 2020; 40:e13-e21. [PMID: 33025702 DOI: 10.1111/ajag.12830] [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: 09/24/2019] [Revised: 05/10/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors independently associated with late claim closure, a proxy for recovery, in older (65+ years) compared to younger (17-64 years) adults following road traffic crash injury (RTI). METHODS Multivariable analysis of statewide compensation data from New South Wales (NSW), Australia, for NSW residents aged ≥17 years injured in a non-catastrophic RTI between July 2010 and June 2013 with finalised claims (n = 16 687). RESULTS Legal representation was the dominant factor independently associated with late claim closure in both age groups. However, the odds were doubly high for the younger group (younger: AOR 8.46, 95% CI 7.7-9.4; older: AOR 3.95, 95% CI 3.1-5.0). Median time to claim closure was shorter for older people. CONCLUSION Older (and younger) claimants with legal representation are at increased risk of late claim closure and can be readily identified within routinely collected compensation data, enabling delivery of targeted strategies or supports early in the claims process.
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Affiliation(s)
- Katherine Brown
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia
| | - Ian D Cameron
- Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Kolling Institute, Royal North Shore Hospital, the University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ha Nguyen
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Kolling Institute, Royal North Shore Hospital, the University of Sydney, Sydney, New South Wales, Australia
| | - Prue Vines
- Faculty of Law, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Scollay CE, Berecki-Gisolf J, Grant GM. Trends in lawyer use in road traffic injury compensation claims. PLoS One 2020; 15:e0231025. [PMID: 32251480 PMCID: PMC7135282 DOI: 10.1371/journal.pone.0231025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/15/2020] [Indexed: 11/25/2022] Open
Abstract
Injury compensation claimants use legal services to help them navigate compensation schemes, including accessing benefits and resolving disputes. Little is known, however, about the extent of lawyer use by compensation claimants, including changes over time. This paper presents findings from one of the largest empirical investigations of lawyer use in an injury compensation setting to date. Using evidence from more than 275,000 claims in the road traffic injury scheme in the state of Victoria, Australia, this study examines the prevalence of, and changes in, lawyer use between 2000 and 2015. The analysis identifies a significant increase in the use of lawyers in the scheme, and explores possible explanations. This study provides critical insights into lawyer use in compensation settings: the steep increase in lawyer involvement has both access to justice and financial implications for compensation schemes, given the associations between lawyer use, claimant outcomes, and long-term scheme viability.
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Affiliation(s)
- Clare E. Scollay
- Faculty of Law, Monash University, Melbourne, Victoria, Australia
| | - Janneke Berecki-Gisolf
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
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Pain, Anxiety, and Depression in the First Two Years Following Transport-Related Major Trauma: A Population-Based, Prospective Registry Cohort Study. PAIN MEDICINE 2019; 21:291-307. [DOI: 10.1093/pm/pnz209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
This study aimed to characterize the population prevalence of pain and mental health problems postinjury and to identify risk factors that could improve service delivery to optimize recovery of at-risk patients.
Methods
This population-based registry cohort study included 5,350 adult survivors of transport-related major trauma injuries from the Victorian State Trauma Registry. Outcome profiles were generated separately for pain and mental health outcomes using the “pain or discomfort” and “anxiety or depression” items of the EuroQol Five Dimensions Three-Level questionnaire at six, 12, and 24 months postinjury. Profiles were “resilient” (no problems at every follow-up), “recovered” (problems at six- and/or 12-month follow-up that later resolved), “worsening” (problems at 12 and/or 24 months after no problems at six and/or 12 months), and “persistent” (problems at every follow-up).
Results
Most participants had persistent (pain/discomfort, N = 2,171, 39.7%; anxiety/depression, N = 1,428, 26.2%) and resilient profiles (pain/discomfort, N = 1,220, 22.3%; anxiety/depression, N = 2,055, 37.7%), followed by recovered (pain/discomfort, N = 1,116, 20.4%; anxiety/depression, N = 1,025, 18.8%) and worsening profiles (pain/discomfort, N = 956, 17.5%; anxiety/depression, N = 948, 17.4%). Adjusted multinomial logistic regressions showed increased risk of problems (persistent, worsening, or resolved) vs no problems (resilient) in relation to female sex, middle age, neighborhood disadvantage, pre-injury unemployment, pre-injury disability, and spinal cord injury. People living in rural areas, motorcyclists, pedal cyclists, and people with head, chest, and abdominal injuries had lower risk of problems.
Discussion
Targeted interventions delivered to people with the risk factors identified may help to attenuate the severity and impact of pain and mental health problems after transport injury.
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Gopinath B, Jagnoor J, Elbers N, Cameron ID. Overview of findings from a 2-year study of claimants who had sustained a mild or moderate injury in a road traffic crash: prospective study. BMC Res Notes 2017; 10:76. [PMID: 28143537 PMCID: PMC5286861 DOI: 10.1186/s13104-017-2401-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 01/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies have shown that in people injured in a road traffic crash, persistent symptoms are common and can lead to significant ongoing personal impact. Hence, elucidating factors associated with the human costs are key to reducing the socio-economic burden of road traffic injuries. Therefore, in this study we aimed to track the experience and key outcomes of persons who had sustained mild/moderate injuries as they returned to health (and work, where relevant) following a road traffic crash. RESULTS It is an inception study cohort of adults who had sustained mild to moderate injuries (that is, except serious injuries) in motor vehicle crashes in New South Wales, Australia, who were recruited and interviewed at baseline (within 3 months of the crash) and at 6, 12 and 24 months post-injury. We found that minor injuries had major impacts on pain ratings, physical and mental well-being, health-related quality of life and return to work and pre-injury participation during the 24 months post-injury phase. Further, for mild to moderately severe injuries, biopsychosocial factors appear to be prognostic indicators of recovery (not the location or type of injury). Examples of key biopsychosocial factors are: age; preinjury health; quality of life; reactions to injury (catastrophising, and pain); social support and the third party insurance compensation system. DISCUSSION This study highlights the considerable impact of apparently "minor" road traffic crash injuries at a population level and suggests targeted approaches to the tertiary prevention of long-term morbidity and disability. Study findings have also reiterated the importance of looking beyond the injury to the 'whole person'.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia. .,John Walsh Centre for Rehabilitation Research, Kolling Institute, Royal North Shore Hospital, Corner Reserve Road & First Avenue, St Leonards, NSW, 2065, Australia.
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia.,The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Nieke Elbers
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
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Construct Validity of the EUROHIS-QOL for Rehabilitation Assessment. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2016. [DOI: 10.1017/jrc.2016.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The use of the EUROHIS as a brief measure of quality of life (QOL) in applied settings is increasingly commonplace, including in rehabilitation assessment contexts. However, there are concerns about the validity of data produced by the measure, chief amongst which is the latent structure underlying scores. This article reports on research conducted to investigate the dimensionality of scores derived from the EUROHIS. In addition, the factorial invariance of the retained model across gender as well as latent mean differences in QOL over age, employment status, and psychiatric severity were examined. Based on 251 responses to the EUROHIS by compensable accident victims, support was found for a complex one-factor model, which was found to be partially replicable across gender. Some evidence for differential item functioning across gender, age, and employment status was found. Finally, a U-shaped effect of age on QOL, characterized by a mid-life nadir, as well as effects of psychiatric severity on QOL, and a marginally significant effect of employment status were evident. Collectively, though the results of the present study yield validation data for the EUROHIS, they also raise concerns about the measure. We offer some tentative guidelines for working with the measure for both researchers and practitioners.
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