Coping in patients with chronic whiplash-associated disorders: a descriptive study
Michael Peolsson and Björn Gerdle
A1 Department of Rehabilitation Medicine, INR, Faculty of Health Sciences University Hospital Linköping Sweden
A2 Department of Pain and Rehabilitation Center University Hospital Linköping Sweden
Objective: There are few studies of the way patients with chronic whiplash-associated disorders cope with pain and other aspects of the condition. This study analyses: (a) gender differences in coping strategies; (b) whether the patients can be sub-grouped based on their coping strategies and whether the sub-groups differ clinically; and (c) the relative importance of background variables, symptoms and coping for quality of life. Design: A descriptive study. Patients: A total of 275 consecutive chronic patients with whiplash-associated disorders referred to a university hospital. Methods: A questionnaire covering background data, pain in different regions, symptoms not directly related to pain, Beck depression inventory, a Coping Strategy Questionnaire, a Life Satisfaction checklist (LiSat-11), SF-36 Health Survey and EuroQol instrument. Results: Three groups of patients were identified with respect to coping. Whether or not active coping strategies were used had little influence on health-related quality of life. When regressing health-related quality of life items, the following regressors were the most important: degree of depression of not directly pain-related symptoms, and catastrophizing cognitions influenced by pain intensities. Conclusion: A mixture of symptoms (pain and depression) and coping (catastrophizing) seem to be interwoven and explain patients' health-related quality of life. These characteristics should be assessed when planning rehabilitation.
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