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Silva Guerrero AV1,2, Maujean A2,3, Setchell J1,4, Sterling M2,3
1University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia, 2University of Queensland, Recovery Injury Research Centre, Brisbane, Australia, 3University of Queensland, Centre of Research Excellence in Recovery Following Road Traffic Injuries, Brisbane, Australia, 4University of Toronto, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital. Department of Physical Therapy, Toronto, Canada
Background: Neck pain remains highly prevalent and costly worldwide. Neck pain conditions are heterogeneous with recent studies showing that patients with WAD report higher levels of pain and disability and show greater tendency for the presence of nociplastic pain compared to non-traumatic neck pain. Further, patients with WAD frequently report symptoms of posttraumatic stress as a result of the motor vehicle crash, symptoms unlikely to be found in patients with non-traumatic neck pain. As such, patients with WAD may have different requirements for information included in reassurance provided to them.
Purpose: This study aimed to identify and compare the reported main concerns, fears and worries associated with patients' conditions of non-traumatic neck pain (NTNP) and Whiplash Associated Disorders (WAD). Additionally, we aimed to determine from a patient's perspective whether their concerns were addressed by their primary care providers.
Methods: .A comparative cross-sectional qualitative study using two online surveys. Using purposive samples, the perceptions of 30 participants with non-traumatic neck pain and 20 participants with WAD were obtained. The answers to the open-ended questions were analysed using a thematic approach and then themes were examined for areas of convergence and divergence/mismatch
Results: Four similar themes emerged from the participants' responses to the survey.
1) Further structural damage
2) Psychological distress
3) Concerns about the future
4) Hardships that eventuate.
Some subthemes differed for each theme. For example, in the theme 'psychological distress' the WAD group had subthemes of uncertainty, driving issues, changing expectations of life, losing purpose of life, whereas, for the NTNP group, subthemes were impact on their mental health and possibility of losing enjoyment of life. Three themes of divergence emerged; one unique theme emerged to WAD
5) Catastrophizing and two unique to NTNP
6) Fear that the pain is ongoing and
7) Interference with daily life.
Two similar themes emerged from the participants' responses to the question about anything that stood out with regard to the way their health practitioner addressed any concern they have with their WAD/NTNP.
1) Concerns were addressed
2) Concerns were not addressed.
Both groups shared all subthemes.
Conclusion(s): Patients with NTNP and WAD reported a wide range of concerns and fears related to their condition. There were several shared themes, but also some discordant ones. Both groups recognised the health practitioners' good qualities of the consultation (i.e. comprehensive examination/ diagnoses and explanations, successful treatment, recommendations/ reports, reassurance, helpfulness, understanding and general trust) to address their concerns. When their concerns were not addressed by the health practitioners, the groups identified the lack of interest/ knowledge/understanding/trust, lack of reassurance or no comprehensive examination/ diagnosis in their responses.
Implications: This detailed comparison may provide information to primary health practitioners about neck pain patients' requirements and needs to reassure them.
Keywords: Reassurance, Non-traumatic neck pain, WAD
Funding acknowledgements: No specific funding was obtained for this study
Purpose: This study aimed to identify and compare the reported main concerns, fears and worries associated with patients' conditions of non-traumatic neck pain (NTNP) and Whiplash Associated Disorders (WAD). Additionally, we aimed to determine from a patient's perspective whether their concerns were addressed by their primary care providers.
Methods: .A comparative cross-sectional qualitative study using two online surveys. Using purposive samples, the perceptions of 30 participants with non-traumatic neck pain and 20 participants with WAD were obtained. The answers to the open-ended questions were analysed using a thematic approach and then themes were examined for areas of convergence and divergence/mismatch
Results: Four similar themes emerged from the participants' responses to the survey.
1) Further structural damage
2) Psychological distress
3) Concerns about the future
4) Hardships that eventuate.
Some subthemes differed for each theme. For example, in the theme 'psychological distress' the WAD group had subthemes of uncertainty, driving issues, changing expectations of life, losing purpose of life, whereas, for the NTNP group, subthemes were impact on their mental health and possibility of losing enjoyment of life. Three themes of divergence emerged; one unique theme emerged to WAD
5) Catastrophizing and two unique to NTNP
6) Fear that the pain is ongoing and
7) Interference with daily life.
Two similar themes emerged from the participants' responses to the question about anything that stood out with regard to the way their health practitioner addressed any concern they have with their WAD/NTNP.
1) Concerns were addressed
2) Concerns were not addressed.
Both groups shared all subthemes.
Conclusion(s): Patients with NTNP and WAD reported a wide range of concerns and fears related to their condition. There were several shared themes, but also some discordant ones. Both groups recognised the health practitioners' good qualities of the consultation (i.e. comprehensive examination/ diagnoses and explanations, successful treatment, recommendations/ reports, reassurance, helpfulness, understanding and general trust) to address their concerns. When their concerns were not addressed by the health practitioners, the groups identified the lack of interest/ knowledge/understanding/trust, lack of reassurance or no comprehensive examination/ diagnosis in their responses.
Implications: This detailed comparison may provide information to primary health practitioners about neck pain patients' requirements and needs to reassure them.
Keywords: Reassurance, Non-traumatic neck pain, WAD
Funding acknowledgements: No specific funding was obtained for this study
Topic: Musculoskeletal: spine; Pain & pain management; Musculoskeletal
Ethics approval required: Yes
Institution: Griffith University/ The University of Queensland
Ethics committee: The University of Queensland HREC.Ethical Review Board Griffith University
Ethics number: 2018000448/2017/050
All authors, affiliations and abstracts have been published as submitted.
