title: Initial healthcare and coping preferences are associated with outcome 1 year after whiplash trauma: a multicentre 1-year follow-up study.
abstract: OBJECTIVE
  Individuals exposed to whiplash collisions have to cope with the stressful event as well as early physical symptoms. As in other chronic pain conditions, coping has been associated with outcome after whiplash. In this study, our aim was to examine whether initial coping preferences were associated with the development of chronic whiplash.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  740 acute whiplash patients were recruited from emergency units and general practitioners after car collisions in Denmark. Within 10 days postinjury, participants were asked what they believed could help them get better. At 12-month follow-up, the level of neck pain and capability to work was obtained. Whether coping preferences (baseline) were associated with outcome was investigated using multiple regression analyses.
  
  
  RESULTS
  Persistent neck pain was most strongly associated with preferring medications (mean difference=1.24 (95% CI 0.67 to 1.82)) and sickness absence (mean difference=1.18 (95% CI 0.53 to 1.82)). Reduced work capability was most strongly associated with preferring medications (OR=3.53 (95% CI 2.13 to 5.86)), sickness absence (OR=3.05 (95% CI 1.80 to 5.17)) and being referred to a physiotherapist/chiropractor (OR=3.03 (95% CI 1.33 to 6.91)). Active coping was associated with better outcomes: Participants preferring to change their lifestyle were protected against reduced work capability (OR=0.11 (95% CI 0.01 to 0.78)). Individuals who wanted to keep living as usual only (no other preference reported) were protected against neck pain (mean difference -1.62 (95% CI -2.39 to -0.84)) and reduced work capability (OR=0.09 (95% CI 0.01 to 0.64)).
  
  
  CONCLUSIONS
  A simple nine-item measure of coping preferences is associated with the development of chronic neck pain and reduced capability to work following whiplash trauma and may be used to identify individuals at risk of poor recovery.
authors: Department of Clinical Science, University of Bergen, Bergen, Norway Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway.
authors: Solbjørg Makalani
authors: SM
authors: Myrtveit
authors: The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark.
authors: Tina
authors: T
authors: Carstensen
authors: Department of Neurology, Danish Pain Research Centre, Aarhus University Hospital, Aarhus, Denmark.
authors: Helge
authors: H
authors: Kasch
authors: The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark.
authors: Eva
authors: E
authors: Ørnbøl
authors: The Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark.
authors: Lisbeth
authors: L
authors: Frostholm
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D059350:Chronic Pain / Q000209:etiology*; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D026882:Manipulation, Chiropractic; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D057240:Patient Preference; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012017:Referral and Consultation; D018582:Sick Leave; D014911:Whiplash Injuries / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D014938:Work Capacity Evaluation; D055815:Young Adult
keywords: ACCIDENT & EMERGENCY MEDICINE; EPIDEMIOLOGY; MENTAL HEALTH; PUBLIC HEALTH; TRAUMA MANAGEMENT