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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000085
Original Article: PDF Only

The Role of Illness Perceptions in Predicting Outcome Following Acute Whiplash Trauma - A Multicenter 12-month Follow-up Study.

Gehrt, Tine Bennedsen BSc; Wisbech Carstensen, Tina Birgitte PhD; Ørnbøl, Eva MSc; Fink, Per Klausen PhD; Kasch, Helge PhD; Frostholm, Lisbeth PhD

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Abstract

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

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

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

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

(C) 2014 by Lippincott Williams & Wilkins

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