Article

PURPOSE: To explore rehabilitation professionals' opinions about the influence
and the pathways of injury compensation (IC) on health and disability in patients
with whiplash associated disorder (WAD). METHODS: Semi-structured interviews were
performed among a purposeful selected sample of Dutch expert-professionals in the
field of rehabilitation of patients with WAD. Inclusion continued until
saturation was reached. Inductive and deductive thematic analyses were performed.
RESULTS: Ten rehabilitation expert-professionals (five females), working as
physician, psychologist or physiotherapist, were interviewed. All
expert-professionals acknowledged that IC can influence rehabilitation, health
and disability. The expert-professionals provided three causal pathways; a
pathway through prolonged distress, a behavioral pathway, and patient
characteristics that may either attenuate or worsen their response. They assess
the influence of IC mainly with interview techniques. Most professionals discuss
the potential influence of IC with their patients, because they want to give
clear information to the patient. Some emphasize that their role is neutral in
relation with the IC. Others mention that financial consequences can accompany
functional improvement. CONCLUSIONS: Rehabilitation expert-professionals believe
that IC may affect rehabilitation, health and disability in patients with WAD.
Three pathways are mentioned by the experts-professionals. IMPLICATIONS FOR
REHABILITATION: According to rehabilitation expert-professionals, an injury
compensation (IC) can lead to distress, by creating a (conscious or unconscious)
conflict of interests within a patient between striving for compensation on one
hand, and recovery on the other hand. Patient characteristics can either
attenuate or worsen IC-related distress. Reliable and valid tools need to be
developed to assess the influence of IC on health, disability and rehabilitation,
and to limit the negative effects. Rehabilitation professionals can discuss the
possible unintended effects of IC with their patients to clarify their current situation.

Langue : ANGLAIS