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Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. (Behavioural medicine and physiotherapy - Pernilla Åsenlöf)
University of Gävle, Gävle, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras , Sweden .
Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund , Sweden.
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2013 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, 293-303 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

PURPOSE

The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

METHOD

A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

RESULTS

When measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

CONCLUSIONS

Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

Place, publisher, year, edition, pages
2013. Vol. 20, no 2, 293-303 p.
Keyword [en]
Coping, Daily assessments, Whiplash-associated disorders, Physical well-being, Emotional well-being
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
URN: urn:nbn:se:uu:diva-174498DOI: 10.1007/s12529-012-9220-yISI: 000318505900017PubMedID: 22382932OAI: oai:DiVA.org:uu-174498DiVA: diva2:527384
Available from: 2012-05-21 Created: 2012-05-21 Last updated: 2017-12-07Bibliographically approved
In thesis
1. A Behavioural Medicine Perspective on Acute Whiplash Associated Disorders: Daily Coping, Prognostic Factors and Tailored Treatment
Open this publication in new window or tab >>A Behavioural Medicine Perspective on Acute Whiplash Associated Disorders: Daily Coping, Prognostic Factors and Tailored Treatment
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to study the daily process of coping, potential prognostic factors for recovery and evaluating an individually tailored behavioural medicine intervention in the acute stage of Whiplash Associated Disorders (WAD). The studies comprised three samples of patients with acute Whiplash Associated Disorders (WAD). All patients were included within the first month after the whiplash occurrence and were recruited from hospital emergency wards in six Swedish communities.

Study I and II included 51 participants generating 260 daily coping diaries (WAD-DCA) during seven days in the acute stage of WAD. In Study I daily stressors and primary appraisal were analysed and in Study II patterns between stressors, appraisals, coping strategy profiles, daily activity level and well-being were described. The results showed a large variety of situations that the individuals perceive as stressful, not only pain itself. High self-efficacy was associated with high degree of physical/mental well-being. Threatening stressors and catastrophic thoughts were associated with low degree of physical and mental well-being. In Study III potential prognostic factors for good as well as poor recovery were studied more closely in a mildly affected sample (MIAS) (n=98) from within the first month after the accident up to one year later. Pain-related disability at baseline emerged as the only indicator of prognosis after 12 months in MIAS. Study IV (n=55) was a randomised control study, were current clinical recommendations of standard self-care instructions (SC) for the management of acute WAD was compared to an individually tailored behavioural medicine intervention delivered via Internet or face-to-face. The results showed that SC was not as effective as the behavioural medicine intervention. By early identification of situation-specific factors and potential behavioural (physical, cognitive and affective) determinants of activity performance, it seems possible to tailor a self-management intervention that decreases pain-related disability, fear of movement and catastrophising and increases self-efficacy. The use of innovative methods such as the Internet of distributing treatment interventions showed to be a good alternative to more traditional forms.

The results of this thesis uncover new insights in understanding the individual’s specific perspective as applied in a behavioural medicine approach in acute WAD.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 66 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 807
Keyword
Behavioural medicine, Acute whiplash associated disorders, Daily coping, Prognostic factors, Tailored treatment, Pain-related disability
National Category
Physiotherapy
Research subject
Physiotherapy; Medical Science
Identifiers
urn:nbn:se:uu:diva-179993 (URN)978-91-554-8458-3 (ISBN)
Public defence
2012-10-12, Sal B41, Ing A11, Biomedicinskt Centrum (BMC), Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-09-21 Created: 2012-08-28 Last updated: 2013-01-22Bibliographically approved

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