Williamson, Esther M. (2010) The role of patient held beliefs about injury and recovery in the development of late whiplash syndrome following an acute whiplash injury. PhD thesis, University of Warwick.

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Abstract

This thesis has investigated the role of patient held beliefs about injury and recovery in the
development of late whiplash syndrome (LWS) following an acute whiplash injury.
Beliefs about injury and recovery have the potential to influence outcome. These beliefs
are potentially modifiable through physiotherapy management and gaining greater
understanding into how they influence outcome can potentially improve physiotherapy
management of acute whiplash injuries.
Mixed methods were used to investigate the role of these beliefs in the development of
LWS. Following a systematic literature review, a prospective cohort study was carried out
to identify risk factors for LWS as well as Neck Disability Index Scores and participant
perceived improvement at follow up. This was complemented by a qualitative study
designed to gain greater insight into the patient’s experience of recovering from a whiplash
injury. Patients’ expectations of outcome were found to influence the development of
LWS, in particular, their expectations of time to recovery. Patients’ expectations of
treatment benefit were found to influence outcome to a lesser degree. The patients’ belief
about their ability to cope with their neck problem (self-efficacy) was shown to influence
outcome in the short term but not long term follow up. The use of passive coping strategies
may moderate the influence of these types of beliefs. The qualitative study highlighted the
importance of realistic expectations, the value of reassurance from health professionals
and how the patient’s understanding of pain are important in identifying potential barriers
to recovery.
This thesis has also presented detailed information about the clinical presentation of
individuals who have sustained a whiplash injury and explored patterns of recovery
amongst individuals. This will help clinicians to understand the nature of whiplash injuries
and how they impact on patients which has the potential to improve patient management.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > RC Internal medicine
Library of Congress Subject Headings (LCSH):	Whiplash injuries -- Psychological aspects, Whiplash injuries -- Treatment
Official Date:	October 2010
Dates:	Date Event October 2010 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Lamb, S. E. (Sallie E.) ; Bridle, Chris
Extent:	396 leaves : ill., charts
Language:	eng
URI:	http://wrap.warwick.ac.uk/id/eprint/49215

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