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Meakes S, Enninghorst N, Weaver N, Hardy BM, Balogh ZJ. Long-term functional outcomes in polytrauma: a fundamentally new approach is needed in prediction. Eur J Trauma Emerg Surg 2024:10.1007/s00068-023-02430-6. [PMID: 38358513 DOI: 10.1007/s00068-023-02430-6] [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: 09/14/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE Modern trauma care has reduced mortality but poor long-term outcomes with low follow-up rates are common with limited recommendations for improvements. The aim of this study was to describe the impact of severe injury on the health-related quality of life, specifically characterise the non-responder population and to identify modifiable predictors of poorer outcomes. METHODS Five-year (2012-2016) prospective cohort study was performed at a level 1 trauma centre. Baseline Short-Form Health Survey (SF36) was collected at admission, and at 6 and 12 months postinjury together with demographics, injury mechanism and severity, psychosocial wellbeing, and return to work capacity. RESULTS Of the 306 consecutive patients [age 52 ± 17 years, male 72%, ISS 21 (17, 29), mortality 5%], 195 (64%) completed questionnaires at baseline, and at 12 months. Preinjury physical health scores were above the general population (53.1 vs. 50.3, p < 0.001) and mental health component was consistent with the population norms (51.7 vs. 52.9, p = 0.065). One year following injury, both physical health (13.2, 95% CI 14.8, 11.6) and mental health scores (6.0, 95% CI 8.1, 3.8) were significantly below age- and sex-adjusted preinjury baselines. Non-responders had similar ISS but with a lower admission GCS, and were more likely to be younger, and without comorbidities, employment, or university education. CONCLUSION Contrary to their better than population norm preinjury health status, polytrauma patients remain functionally impaired at least 1 year after injury. The identified high risk for non-responding group needs more focused efforts for follow-up. A fundamentally different approach is required in polytrauma research which identify modifiable predictors of poor long-term outcomes.
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Affiliation(s)
- Simone Meakes
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, 2310, Australia
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Natalie Enninghorst
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Natasha Weaver
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Benjamin M Hardy
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, 2310, Australia
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Zsolt J Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, 2310, Australia.
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia.
- University of Newcastle, Newcastle, NSW, Australia.
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Abedi M, Aplin T, Gane E, Johnston V. "No Man's Land": the experiences of persons injured in a road traffic crash wanting to return to work in Queensland, Australia. Disabil Rehabil 2024; 46:48-57. [PMID: 36469639 DOI: 10.1080/09638288.2022.2153178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aimed to explore individuals' experiences of return to work (RTW) following minor to serious road traffic injury (RTI) in Queensland, Australia; seek their recommendations if any, on how to provide support for RTW after RTI; and identify the strategies and resources used to return and remain at work after their RTI. METHODS The interpretive description methodological approach was used. Semi-structured interviews were conducted with eligible participants (n = 18) aged 18-65 y who had experienced a minor to serious RTI at least 6 months earlier. Thematic analysis was used to analyse the data. RESULTS Five themes emerged: (1) physical and mental consequences of RTI negatively impact RTW; (2) money matters; (3) RTW support makes a difference; (4) feeling alone and confused in the RTW process; and (5) several strategies and resources helped with return/stay at work after RTI. Regular contact and cooperation with employers and insurers, job modifications, and using social media to obtain information and social support were helpful RTW strategies. Participants recommended timely and appropriate medical care, financial assistance, and educational support. CONCLUSIONS Policy changes to reduce financial stress, increase employer support, and improve injured individuals' knowledge following a RTI are recommended in jurisdictions operating a fault-based scheme.IMPLICATIONS FOR REHABILITATIONThis study identified several factors that can influence return to work (RTW) following minor to serious road traffic injuries (RTIs) in a jurisdiction operating a fault-based compensation scheme.Legislative changes that provide financial assistance to all injured people regardless of their fault-status could reduce financial stress arising from reduced work ability following a road traffic injury.Increasing employer' awareness of the importance of return to work for those with road traffic injuries and reimbursement for possible expenses of providing RTW support for these individuals could increase employability of injured people following RTI.Improving injured individuals' knowledge about return-to-work processes after a road traffic injury could accelerate recovery and return to work.
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Affiliation(s)
- Masoumeh Abedi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
| | - Elise Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Abedi M, Aplin T, Gane E, Johnston V. Exploring the perspectives of key stakeholders in returning to work after minor to serious road traffic injuries: a qualitative study. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:93-106. [PMID: 35723805 DOI: 10.1007/s10926-022-10051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This qualitative study conducted in Queensland, Australia aimed to explore various stakeholders' perspectives on (1) the barriers and facilitators of Return to Work (RTW) for injured persons following minor to serious Road Traffic Injuries (RTI) in a fault-based scheme, and to investigate the changes needed to better support RTW following RTI. METHODS The study was performed using the Interpretive Description methodological approach. Data were collected during interviews (n = 17), one focus group (n = 4), and an open-ended survey (n = 10) with five categories of stakeholders: treating health providers, workplace representatives, legal representatives, rehabilitation advisors, and insurers. Participants were eligible to participate if they had at least one year of employment history in their respective profession in Queensland, Australia, and were experienced in assisting the RTW of people with RTI. Thematic analysis was used to analyse the data. RESULTS Seven themes were extracted reflecting the barriers and facilitators of RTW along with stakeholders' recommendations to address these barriers. These themes were: (1) knowledge is power; (2) stakeholder expertise; (3) early and appropriate treatment matters; (4) insurers could do better; (5) necessity of employers' support; (6) fix the disjointed system; (7) importance of individual factors pre- and post- injury. The main barriers identified were stakeholders' insufficient communication and knowledge on RTW process following RTI. CONCLUSIONS Individual and system barriers identified in this study suggest that RTW after RTI occurs in a complex system requiring the commitment of all stakeholders. This is particularly important for managing knowledge-related barriers by provision of high quality and easily accessible information about the RTW process, disability schemes, and the nature of RTI.
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Affiliation(s)
- Masoumeh Abedi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
| | - Elise Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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Ameratunga S, Samaranayaka A, Wyeth EH, Davie G, Lilley R, Wilson S, Kokaua J, Derrett S. Prevalence and predictors of post-traumatic stress symptoms in 2200 hospitalised and non-hospitalised injured New Zealanders. Aust N Z J Psychiatry 2022; 56:1344-1356. [PMID: 34823376 DOI: 10.1177/00048674211060747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Post-traumatic stress disorder following injuries unrelated to mass casualty events has received little research attention in New Zealand. Internationally, most studies investigating predictors of post-injury post-traumatic stress disorder focus on hospitalised patients although most survivors are not hospitalised. We compared the prevalence and predictors of symptoms suggestive of post-traumatic stress disorder 12 months following injury among hospitalised and non-hospitalised entitlement claimants in New Zealand's Accident Compensation Corporation. This government-funded universal no-fault insurance scheme replaced tort-based compensation for injuries in 1974 since when civil litigation (which can bias post-traumatic stress disorder estimates) has been rare. METHODS A total of 2220 Accident Compensation Corporation claimants aged 18-64 years recruited to the Prospective Outcomes of Injury Study were interviewed at 12 months post-injury to identify symptoms suggestive of post-traumatic stress disorder using the Impact of Events Scale. Multivariable models examined the extent to which baseline sociodemographic, injury, health status and service interaction factors predicted the risk of post-traumatic stress disorder symptoms among hospitalised and non-hospitalised groups. RESULTS Symptoms suggestive of post-traumatic stress disorder were reported by 17% of hospitalised and 12% of non-hospitalised participants. Perceived threat to life at the time of the injury doubled this risk among hospitalised (adjusted relative risk: 2.0; 95% confidence interval: 1.2-3.2) and non-hospitalised (relative risk: 1.8; 95% confidence interval: 1.2-2.8) participants. Among hospitalised participants, other predictors included female gender, Pacific and 'other' minority ethnic groups, pre-injury depressive symptoms, financial insecurity and perceived inadequacies in healthcare interactions, specifically information and time to discuss problems. Among non-hospitalised survivors, predictors included smoking, hazardous drinking, assault and poor expectations of recovery. CONCLUSION One in six hospitalised and one in eight non-hospitalised people reported post-traumatic stress disorder symptoms 12 months following injury. Perceived threat to life was a strong predictor of this risk in both groups. Identifying early predictors of post-traumatic stress disorder, regardless of whether the injury required hospitalisation, could help target tailored interventions that can reduce longer-term psychosocial morbidity.
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Affiliation(s)
- Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Ari Samaranayaka
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Gabrielle Davie
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Rebbecca Lilley
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Suzanne Wilson
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jesse Kokaua
- Centre for Pacific Health, Va'a o Tautai, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.,Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Pozzato I, Kifley A, Craig A, Gopinath B, Tran Y, Jagnoor J, Cameron ID. Effects of seeking compensation on the psychological health and recovery of injured patients: the role of stress vulnerability and injury-related disability. Psychol Med 2022; 52:68-79. [PMID: 32515720 DOI: 10.1017/s003329172000166x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Seeking compensation has been shown to have an adverse effect on the psychological health and recovery of injured patients, however, this effect requires clarification. METHODS A total of 2019 adults sustaining a traffic injury were recruited. Of these, 709 (35.1%) lodged a compensation claim. Interviews occurred at 1-, 6- and 12-month post-injury. Outcomes were psychological distress (posttraumatic stress (PTS) and depressive symptoms) and health-related functioning (HrF) (quality of life measured by EQ-5D-3L and disability by WHODAS) over 12-months post-injury. Covariates included individual stress vulnerability (preinjury, injury-related factors). RESULTS Compared with non-compensation participants, compensation groups had higher stress vulnerability (more severe injuries and negative reactions) and poorer baseline outcomes (psychological health and HrF). After adjustment, we found an effect of compensation on HrF [β-0.09 (-0.11 to -0.07), p < 0.001] and PTS [β = 0.36 (0.16 to 0.56), p = 0.0003], but not on depression [β = -0.07 (-0.42 to 0.28), p = 0.7]. Both groups improved over time. Vulnerable individuals (β = 1.23, p < 0.001) and those with poorer baseline outcomes (PTS: β = 0.06, p = 0.002; HrF: β = -1.07, p < 0.001) were more likely to lodge a claim. In turn, higher stress vulnerability, poor baseline outcomes and claiming compensation were associated with long-term psychological distress and HrF. Nevertheless, concurrent HrF in the model fully accounted for the compensation effect on psychological distress (β = -0.14, p = 0.27), but not vice versa. CONCLUSIONS This study provides convincing evidence that seeking compensation is not necessarily harmful to psychological health. The person's stress vulnerability and injury-related disability emerge as major risk factors of long-term psychological distress, requiring a whole-systems approach to address the problem.
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Affiliation(s)
- I Pozzato
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - A Kifley
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - A Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - B Gopinath
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Y Tran
- Centre of Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - J Jagnoor
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - I D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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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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Heruti I, Levy S, Avitsur R, Deutscher D, Gutvirtz M, Berkovitz T, Shiloh S. Development of the Injury Perceptions Questionnaire (InjPQ). Psychol Health 2017; 33:614-633. [PMID: 29022358 DOI: 10.1080/08870446.2017.1381957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Injuries are major causes of morbidity and mortality in the population. Given the central role of perceptions in self-regulation of health conditions, it is important to investigate how they are perceived. This article describes the development of the Injury Perceptions Questionnaire (InjPQ). METHODS A concurrent study in a diverse sample of injured individuals (n = 333). The internal structure and the reliability (Cronbach's α) of InjPQ sub-scales were explored by factor analyses. Relationships between injury perception dimensions and equivalent illness perception scales and outcome measures (self-assessed health; physical, emotional and social functioning; depression, anxiety and somatisation; satisfaction with life) were investigated. RESULTS The InjPQ was found to represent the following perception scales: injury identity composed of social and body part components, PTSD symptoms, Injury event, Injury specific emotions, Injured self-image, Positive consequences, Responsibility/guilt, Coping, Time distance, Dependency, Healthy self, External attributions and Injury risk factors. The reliability and construct validity of the scales were found adequate. CONCLUSIONS Injury perceptions can be reliably measured. While partly overlapping with equivalent illness perception scales, the InjPQ depicts cognitive dimensions unique to injury that add significantly to explaining variance in outcomes. The InjPQ is recommended for research and clinical use as a measure of injury perceptions.
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Affiliation(s)
- Irit Heruti
- a School of Behavioral Sciences , Tel-Aviv Academic College , Israel
| | - Sigal Levy
- a School of Behavioral Sciences , Tel-Aviv Academic College , Israel
| | - Ronit Avitsur
- a School of Behavioral Sciences , Tel-Aviv Academic College , Israel
| | | | | | | | - Shoshana Shiloh
- c School of Psychological Sciences, the Gordon Faculty of Social Sciences , Tel Aviv University , Israel
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Guest R, Tran Y, Gopinath B, Cameron ID, Craig A. Psychological distress following a motor vehicle crash: evidence from a statewide retrospective study examining settlement times and costs of compensation claims. BMJ Open 2017; 7:e017515. [PMID: 28877951 PMCID: PMC5588945 DOI: 10.1136/bmjopen-2017-017515] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine whether psychological distress associated with musculoskeletal injuries sustained in a motor vehicle crash (MVC), regardless of time of onset, impacts compensation outcomes such as claim settlement times and costs. Second, to identify factors routinely collected by insurance companies that contribute to psychological distress during the compensation process. DESIGN Statewide retrospective study. DATA SOURCE Analysis of the New South Wales statewide (Australia) injury register for MVC survivors who lodged a compensation claim from 2011 to 2013. PARTICIPANTS 6341 adults who sustained a musculoskeletal injury and who settled a claim for injury after an MVC. Participants included those diagnosed with psychological distress (n=607) versus those not (n=5734). MAIN OUTCOME MEASURES Time to settlement and total costs of claims, as well as socio-demographic and injury characteristics that may contribute to elevated psychological distress, such as socio-economic disadvantage, and injury severity. RESULTS Psychological distress in those with a musculoskeletal injury was associated with significantly longer settlement times (an additional 17 weeks) and considerably higher costs (an additional $A41 575.00 or 4.3 times more expensive). Multivariate logistic regression analysis identified risk factors for psychological distress including being female, social disadvantage, unemployment prior to the claim, not being at fault in the MVC, requiring ambulance transportation and rehabilitation as part of recovery. CONCLUSIONS Results provide compelling evidence that psychological distress has an adverse impact on people with musculoskeletal injury as they progress through compensation. Findings suggest that additional resources should be directed toward claimants who are at risk (eg, the socially disadvantaged or those unemployed prior to the claim), the major aim being to reduce risk of psychological distress, such as post-traumatic stress disorder, and associated risk of increased settlement times and claim costs. Prospective studies are now required that investigate treatment strategies for those at risk of psychological distress associated with an MVC.
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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, Sydney, Australia
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, Australia
| | - Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, Australia
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, Australia
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Beck B, Ekegren CL, Cameron P, Edwards ER, Bucknill A, Judson R, Page R, Hau R, Stevenson M, Gabbe BJ. Predictors of recovery in cyclists hospitalised for orthopaedic trauma following an on-road crash. ACCIDENT; ANALYSIS AND PREVENTION 2017; 106:341-347. [PMID: 28710974 DOI: 10.1016/j.aap.2017.06.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/26/2017] [Accepted: 06/25/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND As cycling-related injury rates are on the rise, there is a need to understand the long term outcomes of these patients in order to quantify the burden of injury and to inform injury prevention strategies. This study aimed to investigate predictors of return to work and functional recovery in a cohort of cyclists hospitalised for orthopaedic trauma from crashes occurring on-road. METHODS A retrospective analysis of data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) was conducted for patients who were hospitalised for orthopaedic trauma following a cycling crash that occurred on-road between July 2007 and June 2015. RESULTS There were 1787 injured cyclists admitted at the participating hospitals. Most cyclists were male (79%), resided in major cities (89%) and were in the highest socioeconomic quintile (52%). The majority of crashes were either non-collisions (41%) or collisions with a motor vehicle (35%). A smaller proportion of cyclists who collided with motor vehicles had returned to work and had returned to pre-injury functional levels at 12 months post-injury, when compared to collisions with other impact counterparts and non-collisions. Mixed effects logistic regression models revealed that compensable patients demonstrated lower odds of complete functional recovery and return to work when compared with non-compensable patients. CONCLUSION Cyclists who collided with motor vehicles had worse outcomes compared to crashes with other impact counterparts and non-collision events. These findings provide support for reducing the potential for interaction between cyclists and motor vehicles.
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Affiliation(s)
- Ben Beck
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.
| | - Christina L Ekegren
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia
| | - Elton R Edwards
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Department of Orthopaedic Surgery, The Alfred, Melbourne, Victoria, Australia
| | - Andrew Bucknill
- Department of Orthopaedic Surgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia
| | - Rodney Judson
- Department of Surgery, The University of Melbourne, Victoria, Australia; General Surgery, The Royal Melbourne Hospital, Victoria, Australia
| | - Richard Page
- Barwon Centre of Orthopaedic Research and Education (B-CORE), University Hospital Geelong, Victoria, Australia; School of Medicine, Deakin University, Victoria, Australia
| | - Raphael Hau
- Melbourne Medical School, Northern Hospital, Victoria, Australia
| | - Mark Stevenson
- Melbourne School of Design/Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Farr Institute, Swansea University Medical School, Swansea University, UK
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Gabbe BJ, Simpson PM, Cameron PA, Ponsford J, Lyons RA, Collie A, Fitzgerald M, Judson R, Teague WJ, Braaf S, Nunn A, Ameratunga S, Harrison JE. Long-term health status and trajectories of seriously injured patients: A population-based longitudinal study. PLoS Med 2017; 14:e1002322. [PMID: 28678814 PMCID: PMC5497942 DOI: 10.1371/journal.pmed.1002322] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/11/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Improved understanding of the quality of survival of patients is crucial in evaluating trauma care, understanding recovery patterns and timeframes, and informing healthcare, social, and disability service provision. We aimed to describe the longer-term health status of seriously injured patients, identify predictors of outcome, and establish recovery trajectories by population characteristics. METHODS AND FINDINGS A population-based, prospective cohort study using the Victorian State Trauma Registry (VSTR) was undertaken. We followed up 2,757 adult patients, injured between July 2011 and June 2012, through deaths registry linkage and telephone interview at 6-, 12-, 24-, and 36-months postinjury. The 3-level EuroQol 5 dimensions questionnaire (EQ-5D-3L) was collected, and mixed-effects regression modelling was used to identify predictors of outcome, and recovery trajectories, for the EQ-5D-3L items and summary score. Mean (SD) age of participants was 50.8 (21.6) years, and 72% were male. Twelve percent (n = 333) died during their hospital stay, 8.1% (n = 222) of patients died postdischarge, and 155 (7.0%) were known to have survived to 36-months postinjury but were lost to follow-up at all time points. The prevalence of reporting problems at 36-months postinjury was 37% for mobility, 21% for self-care, 47% for usual activities, 50% for pain/discomfort, and 41% for anxiety/depression. Continued improvement to 36-months postinjury was only present for the usual activities item; the adjusted relative risk (ARR) of reporting problems decreased from 6 to 12 (ARR 0.87, 95% CI: 0.83-0.90), 12 to 24 (ARR 0.94, 95% CI: 0.90-0.98), and 24 to 36 months (ARR 0.95, 95% CI: 0.95-0.99). The risk of reporting problems with pain or discomfort increased from 24- to 36-months postinjury (ARR 1.06, 95% CI: 1.01, 1.12). While loss to follow-up was low, there was responder bias with patients injured in intentional events, younger, and less seriously injured patients less likely to participate; therefore, these patient subgroups were underrepresented in the study findings. CONCLUSIONS The prevalence of ongoing problems at 3-years postinjury is high, confirming that serious injury is frequently a chronic disorder. These findings have implications for trauma system design. Investment in interventions to reduce the longer-term impact of injuries is needed, and greater investment in primary prevention is needed.
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Affiliation(s)
- Belinda J. Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Farr Institute, Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Pam M. Simpson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter A. Cameron
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Ronan A. Lyons
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Farr Institute, Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Insurance Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Mark Fitzgerald
- Trauma Service, The Alfred, Melbourne, Victoria, Australia
- Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Rodney Judson
- Trauma Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Warwick J. Teague
- Trauma Service, The Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Surgical Research Group, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Sandra Braaf
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew Nunn
- Victorian Spinal Cord Service, Austin Health, Heidelberg, Victoria, Australia
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - James E. Harrison
- Research Centre for Injury Studies, Flinders University, Adelaide, South Australia, Australia
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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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Bayen E, Jourdan C, Ghout I, Pradat-Diehl P, Darnoux E, Nelson G, Vallat-Azouvi C, Charenton J, Aegerter P, Ruet A, Azouvi P. Negative impact of litigation procedures on patient outcomes four years after severe traumatic brain injury: results from the PariS-traumatic brain injury study. Disabil Rehabil 2017; 40:2040-2047. [PMID: 28508698 DOI: 10.1080/09638288.2017.1325522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To analyze the effect of litigation procedures on long-term outcomes in severe traumatic brain injury. MATERIALS AND METHODS Prospective observational follow-up of an inception cohort including 504 adults with severe traumatic brain injury recruited in 2005-2007 in the Parisian area, France, with initial, one- and four-year outcomes measures. RESULTS Four years after the traumatic brain injury, 147 patients, out of 257 who survived the acute phase, were assessed. Among these patients, 53 patients declared being litigants and 78 nonlitigants (litigation status was unknown in 16 cases). Sociodemographic characteristics, type of injury and initial severity did not differ significantly between litigants and nonlitigants, except for Injury Severity Score (worse in litigants) and the proportion of road traffic accidents (higher in litigants). One- and four-year outcomes were significantly worse in litigants for autonomy, participation, psychiatric and cognitive function but not quality of life (measured with the Glasgow Outcome Scale-Extended, the working activity status, the Brain Injury Community Rehabilitation Outcome, the Hospital Anxiety and Depression scale, the Neurobehavioral Rating Scale-revised and the Quality of Life after Brain Injury, respectively). Multivariate analyses highlighted litigation procedure as an independent significant predictor of lower autonomy, participation and psychiatric function and tended to predict lower cognitive function, but not lower quality of life, after adjustment for pretrauma characteristics, Injury Severity Score, road traffic accidents and work-related accident status. CONCLUSIONS Patients with severe traumatic brain injury have a worse prognosis when involved in a litigation procedure and require special attention in clinical practice. Implications for rehabilitation The influence of litigation procedure on health and social outcomes in severe traumatic brain injury is a major issue that entail numerous levels of complexities. A wide range of interactions and factors related to the prolonged process of litigation against a third party may influence recovery. Results from the PariS-Traumatic Brain Injury study suggest that patients with a severe Traumatic Brain Injury who are involved in a litigation procedure within French jurisdiction compensation scheme have a worse prognosis than patients who do not. Health professionals should be aware of the potential adverse effects of litigation procedures on recovery, and provide appropriate interventions and information to patients and families in such cases.
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Affiliation(s)
- Eléonore Bayen
- a Physical Medicine and Rehabilitation Department , Pitie-Salpetriere Hospital, APHP , Paris , France ; Health Economics Department LEDa-LEGOS , University Paris-Dauphine , Paris , France
| | - Claire Jourdan
- b Physical Medicine and Rehabilitation Department , Lapeyronie Hospital, CHRU , Montpellier , France
| | - Idir Ghout
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Pascale Pradat-Diehl
- d Physical Medicine and Rehabilitation Department , Pitie-Salpetriere Hospital, APHP , Paris , France ; Laboratoire d'Imagerie Biomédicale Inserm U1146 Sorbonne Universités University Pierre et Marie Curie UMCR2 - CNRS UMR7371
| | - Emmanuelle Darnoux
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Gaëlle Nelson
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Claire Vallat-Azouvi
- e Physical Medicine and Rehabilitation Department , AP-HP, Raymond-Poincaré Hospital , Garches , France ; EA4047 , University of Versailles Saint Quentin , France
| | - James Charenton
- f Regional Reference Center for Bain Injury in the Parisan area, CRFTC , Paris , France
| | - Philippe Aegerter
- c Department of Biostatistics , Ambroise Paré Hospital, APHP UVSQ , Boulogne , France ; EA4047 , University of Versailles Saint Quentin , France
| | - Alexis Ruet
- g Physical Medicine and Rehabilitation Department , CHU Caen , France and INSERM U1077 , France
| | - Philippe Azouvi
- e Physical Medicine and Rehabilitation Department , AP-HP, Raymond-Poincaré Hospital , Garches , France ; EA4047 , University of Versailles Saint Quentin , France
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13
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Young G. PTSD in Court III: Malingering, assessment, and the law. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 52:81-102. [PMID: 28366496 DOI: 10.1016/j.ijlp.2017.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/02/2017] [Indexed: 06/07/2023]
Abstract
This journal's third article on PTSD in Court focuses especially on the topic's "court" component. It first considers the topic of malingering, including in terms of its definition, certainties, and uncertainties. As with other areas of the study of psychological injury and law, generally, and PTSD (posttraumatic stress disorder), specifically, malingering is a contentious area not only definitionally but also empirically, in terms of establishing its base rate in the index populations assessed in the field. Both current research and re-analysis of past research indicates that the malingering prevalence rate at issue is more like 15±15% as opposed to 40±10%. As for psychological tests used to assess PTSD, some of the better ones include the TSI-2 (Trauma Symptom Inventory, Second Edition; Briere, 2011), the MMPI-2-RF (Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form; Ben-Porath & Tellegen, 2008/2011), and the CAPS-5 (The Clinician-Administered PTSD Scale for DSM-5; Weathers, Blake, Schnurr, Kaloupek, Marx, & Keane, 2013b). Assessors need to know their own possible biases, the applicable laws (e.g., the Daubert trilogy), and how to write court-admissible reports. Overall conclusions reflect a moderate approach that navigates the territory between the extreme plaintiff or defense allegiances one frequently encounters in this area of forensic practice.
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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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Craig A, Tran Y, Guest R, Gopinath B, Jagnoor J, Bryant RA, Collie A, Tate R, Kenardy J, Middleton JW, Cameron I. Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis. BMJ Open 2016; 6:e011993. [PMID: 27609849 PMCID: PMC5020848 DOI: 10.1136/bmjopen-2016-011993] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this meta-analysis was to determine the psychological impact associated with motor vehicle crash (MVC)-related physical injuries. DESIGN Systematic review and meta-analysis. DATA SOURCES Multiple search engines included MEDLINE (via OVID), PsycINFO and Embase, and studies were sourced from scientific journals, conference papers and doctoral theses. STUDY SELECTION A high-yield search strategy was employed. Terms like 'psychological distress', 'depression', 'PTSD' and 'motor vehicle accident' were employed. These key words were run primarily and secondary searches were then conducted in association with the major injury types. Studies needed to compare psychological distress in people injured in an MVC with uninjured controls who had not recently experienced an MVC. DATA EXTRACTION Searches resulted in the identification of 2537 articles, and after eliminating duplicates and studies not meeting inclusion criteria, 24 studies were selected involving 4502 injured participants. These studies were entered into separate meta-analyses for mild to moderate traumatic brain injury (mTBI), whiplash-associated disorder (WAD) and spinal cord injury (SCI). RESULTS Elevated psychological distress was associated with MVC-related injuries with a large summary effect size in WAD (0.90), medium to large effect size in SCI (0.69) and small to medium effect size in mTBI (0.23). No studies meeting inclusion criteria were found for burns, fractures and low back injury. Increased psychological distress remains elevated in SCI, mTBI and WAD for at least 3 years post-MVC. CONCLUSIONS Rehabilitation strategies are needed to minimise distress subsequent to MVC-related physical injuries and the scientific robustness of studies requires improvement.
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Affiliation(s)
- Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Yvonne Tran
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Rebecca Guest
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Jagnoor Jagnoor
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Kensington, New South Wales, Australia
| | - Alex Collie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Justin Kenardy
- School of Psychology and Centre of National Research on Disability and Rehabilitation Medicine (CONROD), University of Queensland, Brisbane, Queensland, Australia
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
| | - Ian Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School-Northern, The University of Sydney, St Leonards, New South Wales, Australia
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Abstract
OBJECTIVE To describe the long-term outcomes of major trauma patients and factors associated with the rate of recovery. BACKGROUND As injury-related mortality decreases, there is increased focus on improving the quality of survival and reducing nonfatal injury burden. METHODS Adult major trauma survivors to discharge, injured between July 2007 and June 2012 in Victoria, Australia, were followed up at 6, 12, and 24 months after injury to measure function (Glasgow Outcome Scale-Extended) and return to work/study. Random-effects regression models were fitted to identify predictors of outcome and differences in the rate of change in each outcome between patient subgroups. RESULTS Among the 8844 survivors, 8128 (92%) were followed up. Also, 23% had achieved a good functional recovery, and 70% had returned to work/study at 24 months. The adjusted odds of reporting better function at 12 months was 27% (adjusted odds ratio 1.27, 95% confidence interval [CI] 1.19-1.36) higher compared with 6 months, and 9% (adjusted odds ratio 1.09, 95% CI, 1.02-1.17) higher at 24 months compared with 12 months. The adjusted relative risk (RR) of returning to work was 14% higher at 12 months compared with 6 months (adjusted RR 1.14, 95% CI, 1.12-1.16) and 8% (adjusted RR 1.08, 95% CI, 1.06-1.10) higher at 24 months compared with 12 months. CONCLUSIONS Improvement in outcomes over the study period was observed, although ongoing disability was common at 24 months. Recovery trajectories differed by patient characteristics, providing valuable information for informing prognostication and service planning, and improving our understanding of the burden of nonfatal injury.
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17
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Harrington R, Foster M, Fleming J. Experiences of pathways, outcomes and choice after severe traumatic brain injury under no-fault versus fault-based motor accident insurance. Brain Inj 2015; 29:1561-71. [DOI: 10.3109/02699052.2015.1075142] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Elbers NA, Akkermans AJ, Lockwood K, Craig A, Cameron ID. Factors that challenge health for people involved in the compensation process following a motor vehicle crash: a longitudinal study. BMC Public Health 2015; 15:339. [PMID: 25884199 PMCID: PMC4399435 DOI: 10.1186/s12889-015-1694-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 03/26/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Motor vehicle crashes (MVC) are associated with diminished mental health, and furthermore, evidence suggests the process of claiming compensation following an MVC further increases distress and impedes recovery. However, further research is required on why the compensation process is stressful. The aim of the current study is twofold. The first is to investigate whether the interaction with the insurance agency is associated with anxiety. The second is to explore qualitatively aspects of dissatisfaction with the compensation process. METHODS Participants (N = 417) were injured people involved in a compensation scheme after a motor vehicle crash (MVC) in New South Wales, Australia. Interviews were conducted by phone at 2, 12 and 24 months after the MVC. A suite of measures were used including compensation related measures, pain catastrophising and the anxiety/depressed mood subscale of the EuroQol. The association between predictors and anxiety/depressed mood as the dependent variable were analysed using forward logistic regression analyses. The comments about dissatisfaction with the insurance company were analysed qualitatively. RESULTS The strongest predictor of mood status found was pain-related catastrophising, followed by dissatisfaction with the insurance company. Dissatisfaction was attributed to (1) lack of communication and lack of information, (2) delayed or denied payments of compensation, (3) slow treatment approval and discussions about causality, (4) too much complicated paperwork, and (5) discussions about who was at-fault. CONCLUSIONS Factors were found that contribute to anxiety in the compensation process. The association between catastrophising and anxiety/depressive mood suggests it is worthwhile further investigating the role of negative cognitions in compensation processes. People who score highly on catastrophising after the MVC may benefit from early psychological interventions aiming at addressing negative cognitions. Another important stressor is the interaction with the insurance company. Stress is associated with problems of communication, medical treatment, and claim settlement. This study additionally draws attention to some under recognised problems such as delayed payments. Pro-active claims management could address some of the identified issues, which could improve health of injured people after a MVC.
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Affiliation(s)
- Nieke A Elbers
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| | - Arno J Akkermans
- Amsterdam Centre for Comprehensive Law, Faculty of Law, VU University, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands.
| | - Keri Lockwood
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
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Does Blame Impede Health Recovery After Transport Accidents? PSYCHOLOGICAL INJURY & LAW 2015; 8:82-87. [PMID: 25774242 PMCID: PMC4349958 DOI: 10.1007/s12207-015-9215-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 01/21/2015] [Indexed: 11/28/2022]
Abstract
Blame towards the wrongdoer can be a source of distress for people who are injured in a transport accident. The association between blame and psychological stress is well investigated. In contrast, not much is known about blame and health-care utilization. It is important to investigate whether blame is associated with health-care consumption because it may contribute to our knowledge about what factors have an effect on recovery after transport accidents. The current study involved a total of 2940 participants, who were selected from a compensation database in Victoria, Australia. Health-care utilization, in general, and utilization of psychologist and physiotherapist visits, in particular, were defined as the outcome. In contrast to a previous study, it was found that blaming the other was associated with greater health-care utilization, in general, and psychologists and physiotherapist visits, specifically. Another relevant finding was that, although the study involved a sample that was created to show an equal ratio of blame/no-blame, 61 % blamed the other driver; therefore, blame may be a motive to lodge a claim. Finally, we discuss the role that psychologists and claim managers could play in reducing feelings of blame in order to reduce health-care utilization and possibly improve recovery.
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20
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Undavalli C, Das P, Dutt T, Bhoi S, Kashyap R. PTSD in post-road traffic accident patients requiring hospitalization in Indian subcontinent: A review on magnitude of the problem and management guidelines. J Emerg Trauma Shock 2014; 7:327-31. [PMID: 25400398 PMCID: PMC4231273 DOI: 10.4103/0974-2700.142775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 02/20/2014] [Indexed: 11/10/2022] Open
Abstract
Traumatic events after a road traffic accident (RTA) can be physical and/or psychological. Posttraumatic stress disorder (PTSD) is one of the major psychological conditions which affect accident victims. Psychological issues may not be addressed in the emergency department(ED) immediately. There have been reports about a mismatch between the timely referrals from ED to occupational or primary care services for these issues. If left untreated, there may be adverse effects on quality of life (QOL) and work productivity. Hospital expenses, loss of income, and loss of work could create a never ending cycle for financial difficulties and burden in trauma victims. The aim of our review is to address the magnitude of PTSD in post-RTA hospitalized patients in Indian subcontinent population. We also attempted to emphasis on few management guidelines. A comprehensive search was conducted on major databases with Medical Subject Headings (MeSH) term ‘PTSD or post-traumatic stress’ and Emergency department and vehicle or road or highway or automobile or car or truck or trauma and India. Out of 120 studies, a total of six studies met our inclusion criteria and were included in the review. Our interpretation of the problem is that; hospital expenditure due to trauma, time away from work during hospitalization, and reduction in work performance, are three major hits that can lead RTA victims to financial crisis. Proposed management guidelines are; establish a coordinated triage, implementing a screening tool in the ED, and provide psychological counseling.
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Affiliation(s)
- Chaitanya Undavalli
- Department of Preventive Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Piyush Das
- Department of Psychiatry, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Taru Dutt
- Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sanjeev Bhoi
- Department of Emergency Medicine, AIIMS, New Delhi, India
| | - Rahul Kashyap
- Department of Emergency Medicine, AIIMS, New Delhi, India ; Department of Anesthesiology and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
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Gorman D. What can be learnt from the 1980s Australian and New Zealand work-related musculoskeletal pain epidemics? Intern Med J 2014; 44:717-9. [DOI: 10.1111/imj.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 06/03/2014] [Indexed: 11/24/2022]
Affiliation(s)
- D. Gorman
- The University of Auckland; Auckland New Zealand
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Powers MB, Warren AM, Rosenfield D, Roden-Foreman K, Bennett M, Reynolds MC, Davis ML, Foreman ML, Petrey LB, Smits JAJ. Predictors of PTSD symptoms in adults admitted to a Level I trauma center: a prospective analysis. J Anxiety Disord 2014; 28:301-9. [PMID: 24632075 PMCID: PMC4004712 DOI: 10.1016/j.janxdis.2014.01.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 01/10/2014] [Accepted: 01/25/2014] [Indexed: 11/26/2022]
Abstract
Trauma centers are an ideal point of intervention in efforts to prevent posttraumatic stress disorder (PTSD). In order to assist in the development of prevention efforts, this study sought to identify early predictors of PTSD symptoms among adults admitted to a Level I trauma center using a novel analytic strategy (Fournier et al., 2009). Upon admission, participants (N=327) were screened for PTSD symptoms and provided information on potential predictor variables. Their PTSD symptoms were assessed again 3 months later (N=227). Participants were classified as symptomatic (positive PTSD screen) or asymptomatic (negative PTSD screen) at the follow-up assessment. Multinomial logistic regression showed that age, depression, number of premorbid psychiatric disorders, gunshot wound, auto vs. pedestrian injury, and alcohol use predicted who had PTSD symptoms at FU with 76.3% accuracy. However, when controlling for PTSD severity at baseline, only age, number of premorbid psychiatric disorders, and gunshot wounds predicted PTSD symptoms at FU but with 78.5% accuracy. These findings suggest that psychological prevention efforts in trauma centers may be best directed toward adults who are young, have premorbid psychiatric disorders, and those admitted with gunshot wounds.
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Abstract
BACKGROUND There is considerable evidence that being involved in compensation processes has a negative impact on claimants' health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants' perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants' quality of life. METHOD Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life. RESULTS Participants (n=176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p<.001). The length of hospital stay was positively associated with procedural justice (β=.31, p<.001). Having trunk/back injury was negatively related to procedural justice (β=-.25, p=.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (rs=.22, p=.004). DISCUSSION The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants' health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process.
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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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Elbers NA, Hulst L, Cuijpers P, Akkermans AJ, Bruinvels DJ. Do compensation processes impair mental health? A meta-analysis. Injury 2013; 44:674-83. [PMID: 22244996 DOI: 10.1016/j.injury.2011.11.025] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/10/2011] [Accepted: 11/26/2011] [Indexed: 02/02/2023]
Abstract
BACKGROUND Victims who are involved in a compensation processes generally have more health complaints compared to victims who are not involved in a compensation process. Previous research regarding the effect of compensation processes has concentrated on the effect on physical health. This meta-analysis focuses on the effect of compensation processes on mental health. METHOD Prospective cohort studies addressing compensation and mental health after traffic accidents, occupational accidents or medical errors were identified using PubMed, EMBASE, PsycInfo, CINAHL, and the Cochrane Library. Relevant studies published between January 1966 and 10 June 2011 were selected for inclusion. RESULTS Ten studies were included. The first finding was that the compensation group already had higher mental health complaints at baseline compared to the non-compensation group (standardised mean difference (SMD)=-0.38; 95% confidence interval (CI) -0.66 to -0.10; p=.01). The second finding was that mental health between baseline and post measurement improved less in the compensation group compared to the non-compensation group (SMD=-0.35; 95% CI -0.70 to -0.01; p=.05). However, the quality of evidence was limited, mainly because of low quality study design and heterogeneity. DISCUSSION Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on (mental) health.
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Affiliation(s)
- Nieke A Elbers
- Department of Law, VU University, Amsterdam, The Netherlands.
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Elbers NA, Cuijpers P, Akkermans AJ, Collie A, Ruseckaite R, Bruinvels DJ. Do claim factors predict health care utilization after transport accidents? ACCIDENT; ANALYSIS AND PREVENTION 2013; 53:121-126. [PMID: 23411157 DOI: 10.1016/j.aap.2013.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 11/22/2012] [Accepted: 01/16/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND Injured people who are involved in compensation processes have less recovery and less well-being compared to those not involved in claims settlement procedures. This study investigated whether claim factors, such as no-fault versus common law claims, the number of independent medical assessments, and legal disputes, predict health care utilization after transport accidents. METHOD The sample consisted of 68,911 claimants who lodged a compensation claim at the Transport Accident Commission (TAC) in Victoria, Australia, between 2000 and 2005. The main outcome measure was health care utilization, which was defined as the number of visits to health care providers (e.g. general practitioners, physiotherapists, psychologists) during the 5 year period post-accident. RESULTS After correction for gender, age, role in accident, injury type, and severity of injury, it was found that independent medical assessments were associated with greater health care utilization (β=.36, p<.001). Involvement in common law claims and legal disputes were both significantly related to health care utilization (respectively β=.05, p<.001 and β=-.02, p<.001), however, the standardized betas were negligible, therefore the effect is not clinically relevant. A model including claim factors predicted the number of health care visits significantly better (ΔR(2)=.08, p<.001) than a model including only gender, age, role in accident, injury type, and severity of injury. CONCLUSION The positive association between the number of independent medical assessments and health care utilization after transport accidents may imply that numerous medical assessments have a negative effect on claimants' health. However, further research is needed to determine a causal relationship.
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Affiliation(s)
- Nieke A Elbers
- VU University Amsterdam, Department of Law, De Boelelaan 1105, Amsterdam, The Netherlands.
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Do different types of financial support after illness or injury affect socio-economic outcomes? A natural experiment in New Zealand. Soc Sci Med 2013; 85:93-102. [PMID: 23540372 DOI: 10.1016/j.socscimed.2013.02.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 02/15/2013] [Accepted: 02/25/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND In New Zealand, people unable to work due to an illness may be eligible for a means-tested benefit whereas injured people are eligible for a wide range of support including earnings-related compensation through the no-fault Accident Compensation Corporation (ACC). The effect of this difference on socio-economic outcomes has not been investigated before. METHODS A comparative cohort study was undertaken of stroke versus injury. Individuals aged 18-64, who had a first-stroke (n = 109) were matched by age, sex and functional impairment with injured individuals (n = 429) participating in the Prospective Outcomes of Injury Study. Data were collected by interview 3.5 and 12 months after stroke or injury. Logistic regression adjusting for the matching variables at 3.5 months, and functional impairment at 12 months, was undertaken. RESULTS Median personal income declined by 60% over 12 months for the Stroke Group compared to 13% decline in the Injury Group. Decline in income was greater for those in both groups who had a higher income initially, and for those who had not returned to work. The proportion of the Stroke Group reporting 'Fairly low/low' standard of living increased from 8% to 28% and 'Just/not enough' income increased from 35% to 61% whereas the Injury Group increased only from 5% to 12% and 33%-44% respectively. The odds of reporting low standard of living and income inadequacy at 12 months were significantly less for the Injury Group. Despite earnings-related compensation (80% of income), the odds of being back at work were greater for the Injury Group compared to the Stroke Group (Adjusted Odds Ratio 3.1; 95% CI 1.7-5.6). CONCLUSIONS These findings support the conclusions that earnings-related compensation and rehabilitative support, available to injured people via ACC, largely prevents the downward spiral into poverty and ill health. It also appears to enhance return to work though residual confounding cannot be ruled out.
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Spearing NM, Connelly LB, Nghiem HS, Pobereskin L. Research on injury compensation and health outcomes: ignoring the problem of reverse causality led to a biased conclusion. J Clin Epidemiol 2012; 65:1219-26. [DOI: 10.1016/j.jclinepi.2012.05.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 05/06/2012] [Accepted: 05/09/2012] [Indexed: 11/25/2022]
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Collie A, Fitzharris M, Gabbe B. Evaluation of a compensation claims management intervention for improving recovery from traumatic injury. Injury 2012; 43:1335-6. [PMID: 22766262 DOI: 10.1016/j.injury.2012.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 05/28/2012] [Accepted: 06/02/2012] [Indexed: 02/02/2023]
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Spearing NM, Connelly LB, Gargett S, Sterling M. Does injury compensation lead to worse health after whiplash? A systematic review. Pain 2012; 153:1274-1282. [DOI: 10.1016/j.pain.2012.03.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 02/29/2012] [Accepted: 03/06/2012] [Indexed: 11/30/2022]
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Elbers NA, van Wees KAPC, Akkermans AJ, Cuijpers P, Bruinvels DJ. Exploring Lawyer-Client Interaction: A Qualitative Study of Positive Lawyer Characteristics. PSYCHOLOGICAL INJURY & LAW 2012; 5:89-94. [PMID: 22866183 PMCID: PMC3407555 DOI: 10.1007/s12207-012-9120-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 04/17/2012] [Indexed: 11/27/2022]
Abstract
Personal injury victims involved in compensation processes have a worse recovery than those not involved in compensation processes. One predictor for worse recovery is lawyer engagement. As some people argue that this negative relation between lawyer engagement and recovery may be explained by lawyers’ attitude and communications to clients, it seems important to investigate lawyer–client interaction. Although procedural justice and therapeutic jurisprudence had previously discussed aspects relevant for lawyer–client interaction, the client’s perspective has been rather ignored and only few empirical studies have been conducted. In this qualitative study, 21 traffic accident victims were interviewed about their experiences with their lawyer. Five desirable characteristics for lawyers were identified: communication, empathy, decisiveness, independence, and expertise. Communication and empathy corresponded with aspects already discussed in literature, whereas decisiveness, independence and expertise had been addressed only marginally. Further qualitative and quantitative research is necessary to establish preferable lawyer characteristics and to investigate what would improve the well-being of personal injury victims during the claims settlement process.
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Affiliation(s)
- Nieke A. Elbers
- Faculty of Law, Department of Civil Law, VU University, Amsterdam, The Netherlands
- Faculty of Psychology and Education, Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
- EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Interdisciplinary Center of Law and Health, VU University, De Boelelaan 1105, 1081HV Amsterdam, The Netherlands
| | - Kiliaan A. P. C. van Wees
- Faculty of Law, Department of Civil Law, VU University, Amsterdam, The Netherlands
- Amsterdam Interdisciplinary Center of Law and Health, VU University, De Boelelaan 1105, 1081HV Amsterdam, The Netherlands
| | - Arno J. Akkermans
- Faculty of Law, Department of Civil Law, VU University, Amsterdam, The Netherlands
- Amsterdam Interdisciplinary Center of Law and Health, VU University, De Boelelaan 1105, 1081HV Amsterdam, The Netherlands
| | - Pim Cuijpers
- Faculty of Psychology and Education, Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
- EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Interdisciplinary Center of Law and Health, VU University, De Boelelaan 1105, 1081HV Amsterdam, The Netherlands
| | - David J. Bruinvels
- Faculty of Law, Department of Civil Law, VU University, Amsterdam, The Netherlands
- Amsterdam Interdisciplinary Center of Law and Health, VU University, De Boelelaan 1105, 1081HV Amsterdam, The Netherlands
- Center of Excellence of the Netherlands Society of Occupational Medicine (NVAB), Utrecht, The Netherlands
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
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Gabbe BJ, Harris IA, Collie A, Cameron PA. Does access to compensation have an impact on recovery outcomes after injury? Med J Aust 2010; 193:188; author reply 190. [DOI: 10.5694/j.1326-5377.2010.tb03852.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 05/24/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC
| | - Ian A Harris
- South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Sydney, NSW
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC
| | - Peter A Cameron
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC
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Glozier NS, Large M. Does access to compensation have an impact on recovery outcomes after injury? Med J Aust 2010; 193:188-9; author reply 190. [DOI: 10.5694/j.1326-5377.2010.tb03853.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Collie A, Ellis N. Does access to compensation have an impact on recovery outcomes after injury? Med J Aust 2010; 193:189-90; author reply 190. [DOI: 10.5694/j.1326-5377.2010.tb03855.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC
| | - Niki Ellis
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC
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Studdert DM, Luntz H, Grant G. Does access to compensation have an impact on recovery outcomes after injury? Med J Aust 2010; 193:189; author reply 190. [DOI: 10.5694/j.1326-5377.2010.tb03854.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- David M Studdert
- Faculties of Law and Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC
| | - Harold Luntz
- Melbourne Law School, University of Melbourne, Melbourne, VIC
| | - Genevieve Grant
- Melbourne Law School, University of Melbourne, Melbourne, VIC
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