Maintaining a balance: a focus group study on living and coping with chronic whiplash-associated disorder

Abstract

BackgroundThere is little qualitative insight into how persons with chronic Whiplash-Associated Disorder cope on a day to day basis. This study seeks to identify the symptoms persons with Whiplash-Associated Disorder describe as dominating and explore their self-initiated coping strategies.MethodsQualitative study using focus groups interviews. Fourteen Norwegian men and women with Whiplash-Associated Disorder (I or II) were recruited to participate in two focus groups. Data were analyzed according to a phenomenological approach, and discussed within the model of Cognitive Activation Theory of Stress (CATS).ResultsParticipants reported neck and head pain, sensory hypersensitivity, and cognitive dysfunction following their whiplash injury. Based on the intensity of symptoms, participants divided everyday life into good and bad periods. In good periods the symptoms were perceived as manageable. In bad periods the symptoms intensified and took control of the individual. Participants expressed a constant notion of trying to balance their three main coping strategies; rest, exercise, and social withdrawal. In good periods participants experienced coping by expecting good results from the strategies they used. In bad periods they experienced no or negative relationships between their behavioral strategies and their complaints.ConclusionsNeck and head pain, sensory hypersensitivity, and cognitive dysfunction were reported as participants' main complaints. A constant notion of balancing between their three main coping strategies; rest, exercise, and social withdrawal, was described.

What does coping mean to the worker with pain-related disability? A qualitative study

“…It has been shown that those who expect severe symptoms after a musculoskeletal injury also use less adaptive coping strategies [23]. Given this finding, it may be that coping serves a key role in mediating the observed association between expectations for recovery (and possibly other pain-related beliefs) and actual recovery after a musculoskeletal injury [23][24][25][26][27].…”

Psychiatric and Psychological Perspectives on Chronic Pain

“…Qualitative studies on coping among pain patients underscore the complexity of the strategies that the patients use. 57,88,89 One practical consequence of the idiosyncratic nature of coping is that psychologists who treat pain patients need to be sensitive to the ways in which individual patients construe their conditions and mobilize their coping resources to deal with them. The focus of psychologists on the idiosyncracies of beliefs and coping behaviors of patients stands in contrast to the focus of psychiatrists on placing patients into broad categories based on their DSM-5 diagnoses.…”

Toward Lessening the Rate of Transition of Acute Whiplash to a Chronic Disorder

“…Likewise, studies from 1983 4 and 2006 5 do not vary in their estimates that up to 30% of whiplash-injured individuals have persisting moderate to severe pain and disability, which may signifi cantly impact on their lives. 6 The trajectories of recovery and, importantly, nonrecovery refl ect the limited success of current treatments for acute whiplash, in particular for those individuals who transition to chronicity. 7 It was reasoned that if the rate of transition to chronicity was to be lessened, then it was time to gather experts together, think and refl ect collectively about the state of knowledge, assimilate observations across a spectrum of clinical and research disciplines, and consider new directions in research to drive forward the development and testing of new and innovative management approaches.…”