Griffin A1,2, Moloney N3, Leaver A1, Jagnoor J2,4, Michaleff Z5, Lin C-WC5, Rebbeck T1,2
1The University of Sydney, Faculty of Health Sciences, Lidcombe, Australia, 2John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, Australia, 3Macquarie University, Faculty of Medicine and Health Sciences, Macquarie Park, Australia, 4The George Institute for Global Health, Newtown, Australia, 5The University of Sydney, Sydney School of Public Health, Camperdown, Australia

Background: The meaning of recovery from musculoskeletal injury is complex, and understanding recovery from whiplash is important given the chronic, recalcitrant nature of the condition. Furthermore, the definition of recovery in clinical trials (typically defined by pain and disability) has not always matched subjective patient experiences.

Purpose: The aim of this study was to define the meaning of recovery from whiplash, and the factors influencing recovery. The purpose of this study was to explore meanings of recovery beyond those traditionally used in clinical trials (e.g. pain and disability) by exploring the perceptions of people with chronic whiplash, and their treating physiotherapists.

Methods: This qualitative study consisted of in-depth semi-structured interviews, conducted with 13 patient participants with chronic whiplash and seven physiotherapists. Patient participants were asked what recovery meant to them, and perceptions around barriers and facilitators to recovery were explored. Physiotherapists were also asked to share their beliefs on the meaning of recovery, and what they believe recovery means to their patients. Data were analysed using an interpretive descriptive approach.

Results: Both patient participants and physiotherapists perceived recovery to be defined within the themes of pain, function and emotional wellbeing. Patient participants also identified self-perception as important, whilst physiotherapists identified ownership on the part of the patient, and the multidimensional nature of recovery, including cultural values and beliefs, as important. Several themes relating to barriers and facilitators to recovery were also identified, and included personal and social characteristics and aspects of the therapeutic relationship.

Conclusion(s): In addition to pain intensity and disability, the conceptualization of recovery involved aspects of emotional wellbeing, self-perception, and the cultural values and beliefs of the individual. A positive therapeutic relationship, with attention to psychological and social influences, appears important in facilitating recovery and wellbeing.

Implications: Recovery is a multidimensional and complex construct. Practitioners must consider the complex and patient-specific nature of recovery when assessing recovery in their patients. Establishing the meaning of recovery to the individual through direct questioning, for example, 'what does recovery mean to you?' is essential and recommended.

Keywords: whiplash injuries, qualitative research, musculoskeletal pain

Funding acknowledgements: The New South Wales State Insurance Regulatory Authority funded the project. TR is supported by a NHMRC Fellowship.

Topic: Musculoskeletal: spine; Outcome measurement; Musculoskeletal

Ethics approval required: Yes
Institution: The University of Sydney
Ethics committee: The University of Sydney Human Research Ethics Committee
Ethics number: 2015/761

All authors, affiliations and abstracts have been published as submitted.

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