title: Stressful events and coping related to acute and sub-acute whiplash-associated disorders.
abstract: Purpose To describe daily stressors affecting and coping strategies employed by individuals with whiplash-associated disorders (WAD) immediately to one month (acute) and three to four months (sub-acute) after injury events using a daily coping assessment. Levels of pain, anxiety, depressed mood and activity are also compared between phases. Method A descriptive prospective design with a content analysis approach was used. Participants completed daily coping assessments for one week during both acute and sub-acute phases. Main measure was whiplash-associated disorders-daily coping assessment (WAD-DCA). Results Nine participants used words describing recovery in the sub-acute phase; 31 described stressful events during both phases. Most frequently reported stressors were related to "symptoms", "emotions" and "occupations/studies". These were equally reported during both phases. Cognitive coping strategies were employed more often during the sub-acute phase (p = 0.008). The only behavioral strategy that increased in prevalence over time was the "relaxed" strategy (p = 0.001). Anxiety levels declined over time (p = 0.022). Conclusion The reported stressors were largely uniform across both acute and sub-acute phases; however, the use of cognitive coping strategies increased over time. The WAD-DCA captures individual stressors and coping strategies employed during a vulnerable phase of rehabilitation and can thus provide information that is useful to clinical practice. Implications for rehabilitation The WAD-DCA provides valuable information for clinical practice when employed during early phases of whiplash-associated disorder development. Reported stressors during the acute and sub-acute phases are essentially the same, whereas cognitive coping strategies grow in prevalence over time. Tailored treatments in early phases of whip-lash associated disorders may benefit from strategies aimed at matching patient-specific stressors with contextually adapted coping strategies.
authors.affiliation: a Department of Neuroscience, Section of Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Pettersson
authors.affiliation: a Department of Neuroscience, Section of Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Bring
authors.affiliation: a Department of Neuroscience, Section of Physiotherapy , Uppsala University , Uppsala , Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Åsenlöf
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D020127:Recovery of Function; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors; D014911:Whiplash Injuries / Q000523:psychology*
keywords: Coping; daily coping assessment; stressor; whiplash-associated disorder