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Personal Experience of Sufferers from Whiplash Injury Compared To the Experience of Doctors Managing the Condition

By Frances Rogers

Abstract

This qualitative study takes an interpretative phenomenological approach to understand the experience of whiplash injury from the different perspectives of patient and doctor. This was carried out in order to identify what psycho-social consequences might be experienced by patients as a result of that injury and to identify any implications for healthcare provision.\ud \ud \ud The research was conducted in two phases. During Phase One, eight patients were recruited through GP practices using a combined approach of retrospective and prospective sampling. Three semi-structured interviews and one telephone interview were carried out with each participant over a twelve month period. In keeping with phenomenological methodology, data were analysed using Template Analysis (King, 2004) and a set of themes relating to healthcare experience were identified: „embodiment‟ „experience of pain‟ „disruption to lifestyle‟, „making sense‟, „patient as expert‟ and „whiplash: a minor injury?‟.\ud \ud \ud During Phase Two, one semi-structured interview was carried out with eight doctors who worked in either the primary or secondary care settings. Data were analysed using Template Analysis and a set of themes relating to their experiences of treating patients was identified: „expectations regarding what patients will experience‟, „what patients do about their whiplash injury‟, „what doctors do‟ and „blame if things go wrong‟.\ud \ud \ud These findings show how the patient participants‟ physical and psychological experiences of their malfunctioning body had consequences for maintaining their sense of self and their ability to carry out their normal everyday activities at home and work. The doctors‟ own expectations of treating patients with whiplash injury and whether or not they trust the patients‟ account have illustrated three approaches: dismissive, reactive or proactive that have different implications for patients‟ experiences of healthcare. The study shows how the notion of „compensation‟ is implicated in whether or not the doctor feels able to trust the patient‟s account.\ud \ud \ud The implications of these findings can be seen in terms of methodological focus, general practice and policy formulation. Methodologically interpretative phenomenology provides a theoretical foundation that is, at the very least, equal to and able to challenge more „traditional scientific foundations‟ through its focus on meaning. In terms of practice and policy formulation, the findings have provided a unique insight that might prove to be beneficial for understanding the health care experience and assist in the provision of guidelines aimed at the treatment of whiplash injury. Indeed it is advocated that doctors adopt a subjective approach and that this is taken into account in training

Topics: R1, RT
OAI identifier: oai:eprints.hud.ac.uk:10159

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Citations

  1. (2002). [Whiplash Injuries-- a psychosomatic perspective] Original title Nakkesdader med whiplashmekanisme-- et psykosomatisk perpektiv.Tiddskrift for den Norseke laegeforening.
  2. (2006). 86 Management of patients with dementia: A national clinical guideline. www.sign.ac.uk/pdf/sign86.pdf (accessed 23
  3. (1987). A new clinical model for the treatment of low back pain.
  4. (1974). A psychological analysis of tension headache.
  5. (2001). A Unique Panic Disorder Presentation Among Khmer Refugees: The sore neck syndrome.
  6. (2004). a) Using Templates in the Thematic Analysis of Texts.
  7. (2008). ABI reveals whiplash epidemic: ABI London. Available at: ‹http://www.abiww.abi.org.uk/Media?releases/2008/11/ABI_reveals_whiplash -epidemic.aspx/› [accessed 17
  8. (1961). Accident neurosis.
  9. (2008). Acute stress response and recovery after whiplash injury.
  10. (1999). Adaptation processes and Quality of Life. doi
  11. (2009). Administrative Gatekeeping-A Third Way Between Unrestricted Patient Advocacy And Bedside Rationing.
  12. (1997). After The Crash: Assessment and treatment of motor vehicle Accident Survivors.
  13. (2001). An A-Z of Counselling Theory and Practice (3rd edition).
  14. (1989). An empirical assessment of pain beliefs.
  15. (1987). Avoidance Behaviour and its Role in Sustaining Chronic Pain. Behaviour Research Therapy.
  16. (2004). b) Using Interviews in Qualitative Research.
  17. (1976). Behavioural Methods for Chronic Pain and Illness. St Louis,
  18. (1927). Being and Time [trans. J.Macquarrie& E Robinson].
  19. (1986). Being epileptic coming to terms with stigma. Sociology of Health and Illness.
  20. (1999). Beyond Pain: The role of fear and avoidance in chronicity.
  21. (1996). Biopsychosocial Perspectives on Chronic Pain In
  22. (2007). Children‟s Adjustment to Parental Cancer A Theoretical Model Development. Cancer Nursing. doi
  23. (1982). Chronic illness as a biographical disruption‟ doi
  24. (2002). Code of professional conduct.
  25. (2002). Cognitive Behaviour Therapy: a guide for the Practising Clinician. East
  26. (1976). Cognitive Therapy and Emotional Disorders.
  27. (1979). Cognitive Therapy of Depression.
  28. (1992). Compensation and chronic pain doi
  29. (2004). Concepts of Rehabilitation For The Management Of Common Health Problems. London: The Stationary Office.
  30. (2006). Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents.
  31. (1963). Control and training of individual motor units.
  32. (1992). Deciphering chronic pain.
  33. (2003). Deconstructing reflexivity. In
  34. (1992). Depressive symptomatology, self esteem, and self blame in battered women. doi
  35. (1994). Descarte‟s error.
  36. (1992). Description versus interpretation: competing alternative strategies for qualitative research.‟
  37. (1999). Designing Qualitative Research (3 rd edition). Thousand Oakes,
  38. (1999). Designing Qualitative Research (3rd edition). Thousand Oakes,
  39. (2001). Developing a dynamic model of treatment perceptions‟. doi
  40. (2002). Different perspectives of doctor and patient in communication.
  41. (1981). Disease versus illnessin general practice.
  42. (2007). Doctors‟ responses to patients with medically unexplained symptoms who seek emotional support: criticism or confrontation? General Hospital Psychiatry.
  43. (2006). Does the achievement of medical identity limit the ability of primary care practitioners to be patient-centred?: A qualitative study. Patient Education and Counselling.
  44. (2000). Doing Qualitative Research.
  45. (1993). Doing research on sensitive topics.
  46. (2005). Editorial Does it take two to Tango.
  47. (2002). Editorial Where Do Interventions Come From.
  48. (1995). Education and Debate Qualitative Research: Introducing focus groups.
  49. (1997). Education and Debate The case against.
  50. (1992). Effect of compensation on emotional state and disability in chronic back pain.
  51. (2000). Effects of Eliminating Compensation For Pain and Sufferring On The Outcome Of Insurance Claims For Whiplash Injury. The New England doi
  52. (1994). Effects of road traffic accidents on travel.
  53. (2004). Embodiment clinical, critical and cultural perspectives on health and illness.
  54. (2001). Engaging With Phenomenology: Is It More of a Challenge Than It Needs To Be? Qualitative Health Research. doi
  55. (1999). Evaluating health interventions for older people Health 3:151-166 Burns, doi
  56. (2003). Evaluation of an evidence based patient educational booklet for management of whiplash associated disorders. doi
  57. (2002). Evidence base of clinical diagnosis: Clinical problem solvingand diagnostic decision making: selective review of the cognitive literature.
  58. (1998). experience of agonising pain and signals of embodiment.
  59. (2001). Experiencing illness through storytelling.
  60. (1986). Experimental Phenomenology; An introduction.
  61. (2004). Family consequences of chronic back pain.
  62. (2000). Fear – avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
  63. (1998). Fear-avoidance theories. In
  64. (1994). Findings and outcomes in whiplash-type neck distortions Spine.
  65. (2001). Focusing on Lived Experience: The evolution of clinical method in Western Medicine.
  66. (1932). Fraud in Medico-Legal Practice (2 nd edition).
  67. (1932). Fraud in Medico-Legal Practice (2nd edition).
  68. (1984). From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlow Park California. London.
  69. (2000). Generalised Musculoskeletal Pain As A Rational Reaction To a Life Situation.
  70. (2003). Giving information to patients.
  71. (1991). Good days bad days; the self in chronic illness and time.
  72. (1989). Grounded Interpretive Research: An investigation of physician socialization.
  73. (2009). Health & Clinical Excellence.
  74. (2004). Health and Illness: A hermeneutical phenomenological approach. In
  75. (1990). Health and Lifestyles.
  76. (1974). Health Belief Model: Origin and correlates in psychological theory. Health education Monographs.
  77. (1995). Health care rationing.
  78. (2007). Health Information Seeking Behaviour.
  79. (2004). Health Psychology: A Textbook.
  80. (2005). Hermeneutic phenomenology: the science of interpretation of texts.
  81. (2001). HIV stigma and health: integration of theoretical concepts and the lived experiences of individuals.
  82. (1996). Holistic thinking: personhood and the biopsychosocial model. In
  83. (1997). Husserl Phenomenology and nursing‟.
  84. (1960). Illness behaviour and medical diagnoses doi
  85. (2010). In-Depth Interviewing.
  86. (1928). Injuries to the cervical spine. Presentation to the annual meeting of the Western Orthopedic Association.
  87. (2007). International Classification of Diseases. WHO available online www.whoint/classifications/icd/en
  88. (1997). Interpretative Phenomenological Analysis In
  89. (2009). Introducing Existential-Phenomenological Psychology. In
  90. (2001). Introducing Qualitative Research
  91. (1995). Introduction: the relationship between physical and psychiatric pathology. In Psychiatric Aspects of Physical Disease. Allan House (Ed) London: Royal College of Physicians of London.
  92. (2000). Investigating Phenomenal consciousness: New methodologies and maps.
  93. (2005). Is employment good for well being? A literature review.
  94. (2002). Is there a moral duty for doctors to trust patients?
  95. (2006). Is Work Good For your Health And Well-Being. London: The Stationary Office.
  96. (1999). Journal Club. A Review and Methodologic Critique of the Literature Refuting Whiplash Syndrome.
  97. (1998). Just listening: Narrative and deep illness.
  98. (2003). Kirklees District Road Injuries.
  99. L.(1998) Cognitive complaints in patients after whiplash injury: the impact of malingering.
  100. (1969). Learning of visceral and glandular responses.
  101. (1992). Living and Relating: An introduction to phenomenology.
  102. (1988). Living with Chronic Illness.
  103. (1995). Long –term outcome after whiplash injury. A 2year follow-uo considering features of injury mechanism and somatic, radiologic and psychological findings.
  104. (1983). Loss of self: A fundamental form of suffering in the chronically.
  105. (1994). Making Sense of Illness: The social psychology of health and disease.
  106. (2006). Malingering, Perceptions of Illness, and Compensation Seeking in Whiplash Injury: A comparison of illness beliefs between individuals in simulated compensation scenarios and litigation claimants.
  107. (2008). Management of upper limb disorders and the biopsychosocial model. RR596. Norwich: Health and Safety Executive. Available from www.hse.gov.uk.
  108. (1988). Meanings at Risk: The Experience of Arthritis. In
  109. (1998). Medical compliance as an ideology‟.
  110. (2003). Medication compliance research: Still so far to go‟.
  111. (1988). Minor whiplash head injury with major debilitation. doi
  112. (2004). Models of Health Care Rationing. Current Sociology.
  113. (1993). Neck injuries from rear impact road traffic accidents: prognosis in persons seeking compensation.
  114. (1996). neck injury. doi
  115. (1973). Neck sprain Associated Factors.
  116. (2009). Negotiated or taken-for-granted trust? Explicit and implicit interpretations of trust in a medical setting.
  117. (1995). Neurosis‟ Revisited: Outcome Studies of the effect of litigation
  118. (2000). Objectivity and reliability in qualitative analysis: realist, contextualist and radical constructionist epistemologies‟. Qualitative Health Research.
  119. (1979). On the relation of injury to pain.
  120. (1995). OPCS Morbidity Statistics from General Practice Fourth national study 1991-1992. London: Her Majesty‟s Stationary Office.
  121. (2002). Outcome 3years after a road traffic accident. doi
  122. (1996). Outcome of „whiplash „neck injury. doi
  123. (2006). Overcoming Depression and Low Mood: A five areas approach (2nd edition).
  124. (2006). Overcoming Depression and Low Mood: A five areas approach nd edition).
  125. (1983). Pain and Behavioural Medicine: A Cognitive-Behavioural Perspective.
  126. (1927). Pain in its medico-legal aspect.
  127. (2000). Pain Management: An Interdisciplinary Approach.
  128. (1993). Pain perceptions emotions and gender.
  129. (1999). Pain related fear is more disabling than pain itself: evidence on the role of pain-related fear on back pain disability.
  130. (1997). Pain: Theory, research and intervention.
  131. (2003). Participating in medical education: views of patients and carers living in deprived communities.
  132. (2009). Patient and Physician perceptions of the Physician‟s Explanation and Patient responses to Physicians.
  133. (2000). Patient Partcipation: The patient‟s voice in primary care.
  134. (1995). Patient-Centred Medicine: Transforming the clinical method. Thousand Oaks:
  135. (1999). Patients‟ perceptions of medical explanations for somatisation disorders: qualitative analysis.
  136. (2005). Pediatric Residents‟ Responses That Discourage Discussion of Psychosocial problems in Primary Care.
  137. (1999). Person- Centred Counselling in Action (2 nd edition).
  138. (1999). Person- Centred Counselling in Action (2nd edition).
  139. (2007). Phenomenological Psychology: theory, research and method. Pearson Education Limited:
  140. (1994). Phenomenological research methods.
  141. (2003). Phenomenology. In J.A Smith.(Ed) Qualitative psychology: a practical guide to research methods.
  142. (2000). Physiotherapy Pain Association Yearbook Topical Issues in Pain 2: Biopsychosocial assessment and management relationships and pain.
  143. (2006). Physiotherapy Pain Association Yearbook Topical Issues in Pain 5: Treatment communication return to work cognitive behavioural pathophysiology.
  144. (1999). Point of View. Whiplash: Heading for a Higher Ground.
  145. (1993). Post –traumatic stress disorder in Vietnam veterans. In
  146. (2006). Prescribed diseases. London: Industrial Industries Advisory Council. www.iiac.org.uk/pdf/dwp-d031890-editpdf (accessed 27
  147. (1988). Prospects of Heart Surgery: Psychological adjustment to coronary bypass grafting.
  148. (1993). Psychiatric consequences of road traffic accidents.
  149. (1998). Psychiatric Morbidity Following Motor Vehicle Accidents: A Review of Methodological Issues.
  150. (2004). Psychosocial factors in medical and psychological treatment avoidance: the role of the doctor-patient relationship‟
  151. (1999). Psychosocial Factors in Pain: Critical Perspectives.
  152. (2003). Qualitative Psychology.
  153. (1998). Qualitative research methods in health technology assessment: a review of the literature.
  154. (2004). Qualitative Researching (2 nd edition).
  155. (2004). Qualitative Researching (2nd edition).
  156. (1992). Rationing America‟s Medical Care: The Oregon Plan and Beyond.
  157. (1993). Real World Research: A resource for social-scientists and practitioner-researchers.
  158. (2001). Reflections on Bodily Change: The Lived Experience of Disability.
  159. (2000). Rethinking Health Psychology.
  160. (1998). Review A review of post-traumatic stress disorder. Part 1: Historical development and classification.
  161. (2000). Road Accidents Great Britain:
  162. (2007). Road Casualties Great
  163. (2005). Road Casualties Great Britain 2004: annual report.
  164. (2000). Scientific Contribution The body uncanny- Further steps towards a phenomenology of illness.
  165. (1995). Secondary Gain Concept: A review of the scientific evidence.
  166. (1998). Sick role‟or „empowerment‟? The ambiguities of life with an HIV positive diagnosis.
  167. (1985). Sketch of a psychological phenomenological method.
  168. (1964). Social Structure and Personality.
  169. (1977). Sociobehavioural determinants of compliance with health and medical care recommendations.
  170. (1996). Spine Update: Impaired cognitive functioning after whiplash injury of the cervical spine.
  171. (1990). Stigma: Notes on the management of spoiled identity.
  172. (2006). Successful Qualitative Health Research: A practical introduction. UK:
  173. (1994). Successful treatment of Low Back Pain and Neck Pain after a Motor Vehicle Accident Despite Litigation.
  174. (1990). The Absent Body.
  175. (1997). The Behavioural response to whiplash injury.
  176. (1996). The biopsychosocial model. In
  177. (1997). The Bodily Nature of Consciousness: Sartre and contemporary philosophy of mind.
  178. (2003). The Body in Health and Illness.
  179. (2006). The body‟s disclosure in phenomenological research Qualitative Research in Psychology 3:
  180. (2003). The child version of the pain catastrophizing scale (PCS-C); a preliminary validation.
  181. (2002). The Clinical Picture of Whiplash Injuries.
  182. (2002). The cognitive treatment of depression. In Simos, G (Ed) Cognitive Behaviour Therapy: a guide for the Practising Clinician. East Sussex:
  183. (2001). The complementarity of phenomenology, hermeneutics and existentialism as a philosophical perspective for nursing research‟.
  184. (1936). The Crisis of European Sciences and Transcendental Phenomenology [trans. D Carr]. IL:
  185. (1984). The crisis of physical illness: An overview and conceptual approach. In
  186. (2003). The development of psychological changes following whiplash injury.
  187. (1999). The development of the UK NHS in the last decade of the 20th Century. Institute for Heath Sector Development.
  188. (1998). The Economic and Social Consequences of Work-related Musculoskeletal Disorders: The Connecticut upper-extremity surveillance project (CUSP)
  189. (1993). The effect of litigation on recovery from whiplash.
  190. (1996). The effect of litigation status on adjustment to whiplash injury.
  191. (1998). The Foundation of Social Research: Meaning and perspective in the research process.
  192. (1997). The Greatest Benefit to Mankind: A medical history of Humanity.
  193. (1999). The Impact of Chronic Illness on the Self System. In
  194. (2005). The Interpreted World: An Introduction to Phenomenological Psychology. (2 nd edition)
  195. (2005). The Interpreted World: An Introduction to Phenomenological Psychology. (2nd edition)
  196. (2003). The intertwining of body, self and world: A phenomenological study of living with recently-diagnosed multiple sclerosis.
  197. (2001). The Lived Experience Of Pain In The Context Of Clinical Practice.
  198. (1992). The Meaning of Illness: A Phenomenological Account of the Different Perspectives of Physician and Patient.
  199. (1977). The need for a new medical model: A challenge for biomedicine.
  200. (2002). The NHS Plan. The Stationery Office: London.
  201. (2009). The online medical dictionary. www.medilexicon.com (accessed 3rd
  202. (2009). The online medical dictionary. www.medilexicon.com (accessed rd
  203. (1991). The Patient‟s Charter.
  204. (2002). The Personal Experience of
  205. (1998). The personal; experience of chronic benign lower back pain: An interpretative phenomenological analysis.
  206. (2001). The Phenomenology of Health and Illness.
  207. (1991). The phenomenon of trust and the patient –physician relationship. In
  208. (2001). The relation between initial symptoms and signs and the prognosis of whiplash.
  209. (2004). The Relationship Between Phobic Travel Anxiety and the Physical Symptoms of Whiplash Injury. Rehabilitation Psychology.
  210. (2000). The relationship of gender to pain, pain behaviour and disability in osteoarthritis patients: the role of catastophizing.
  211. (1987). The Second Medical revolution: From Biomedicine to Infomedicine. Shambhala: Boston and London.
  212. (2001). The Shifting Perspectives Model of Chronic Illness.
  213. (1998). The Social Context of Health.
  214. (1988). The study of sensitive subjects‟.
  215. (1996). The use of self in qualitative research.
  216. (2002). The Whiplash Book. London: The Stationery Office.
  217. (1993). The whiplash syndrome: pathology and physical therapy
  218. (1983). The Wounded Soldiers of Industry: Industrial compensation policy 1833-1897.
  219. (2006). Toward a trajectory of identity reconstruction in chronic fatigue syndrome / myalgic encephalomyelitis: A longitudinal qualitative study.
  220. (2003). Towards a Critical Health Psychology Practice.
  221. (1995). Transcending the dualisms towards a sociology of pain.
  222. (2004). Understanding People. Hampshire: Palgrave Macmilllan.
  223. (1999). Using codes and code manuals: a template organising style of interpretation.
  224. (1987). Whiplash headache.
  225. (1989). Whiplash injury a reappraisal.
  226. (1999). Why Embodiment Now?
  227. (1996). Why people use health services‟ Millbank Memorial Fund Quarterly 44:94-124
  228. (2008). Working for a healthier tomorrow: Dame Carol Black‟s Review of the Health of Britain‟s working age population. London: The Stationary Office.
  229. (2005). Workplace interventions for people with common mental health problems: evidence review and recommendations. British Occupational research Foundation:
  230. (2002). You Can‟t Cure It So You Have To Endure It”: The experience of diabetic renal disease. Qualitative Health research.

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