Advertisement

Psychological Injury and Law

, Volume 3, Issue 3, pp 220–229 | Cite as

Validity and Determinants of Clinicians’ Return to Work Judgments for Individuals Following Whiplash Injury

  • Whitney Scott
  • Michael J. L. SullivanEmail author
Article

Abstract

Rehabilitation clinicians routinely make judgments about the capacity of individuals to return to work following whiplash injury, which can have serious implications for individuals’ continued access to salary indemnity benefits. The present study examined the validity and determinants of these judgments. During a standardized rehabilitation intervention, data regarding demographic factors, crash characteristics, pain severity, range of motion, pain-related psychological functioning, as well as change in the latter three factors over the course of treatment were collected for 104 whiplash-injured individuals (73 women, 31 men). Upon completion of the intervention, clinicians rated the number of hours each individual was capable of working per day. Follow-up data regarding the actual number of hours worked were collected 1 year later. Hierarchical regression analyses revealed that clinicians’ judgments added significant unique variance to the return to work prediction beyond other predictive factors, and that clinicians were particularly influenced by patients’ pain severity and treatment-related change in pain severity in making these judgments. Although clinicians were significantly able to predict return to work, the limited variance accounted for by their judgments (12%) warrants caution in the use of these judgments in decisions related to access to services or indemnity. Factors predictive of clinician judgment and actual return to work are compared, and recommendations to enhance the utility of these judgments are made.

Keywords

Whiplash injury Neck pain Disability Work readiness 

Notes

Acknowledgements

The authors thank Nicole Davidson for her assistance data entry and database management. The authors also wish to thank Maria Milioto, Élyse Marois, Julie Piché and Isabelle Cournoyer for their collaboration. This research was supported by grants from the Fonds de la recherche en santé du Québec (FRSQ) and the Canadian Institutes of Health Research (CIHR).

Conflicts of Interest

The authors have no financial interests related to the content of this paper.

References

  1. Adams, H., Ellis, T., Stanish, W. D., & Sullivan, M. J. L. (2007). Psychosocial factors related to return to work following rehabilitation of whiplash injuries. Journal of Occupational Rehabilitation, 17, 305–315.CrossRefPubMedGoogle Scholar
  2. Arnau, R. C., Meagher, M. W., Norris, M. P., & Bramson, R. (2001). Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients. Health Psychology, 20, 112–119.CrossRefPubMedGoogle Scholar
  3. Automobile Insurance Act (1989). In: Revised Statutes of Quebec, Chapter A-25. Publications Québec, Quebec.Google Scholar
  4. Beals, R. K., & Hickman, N. W. (1972). Industrial injuries of the back and extremities. Journal of Bone and Joint Surgery, 54-A, 1593–1611.Google Scholar
  5. Beck, A., Steer, R., & Brown, G. K. (1996). Manual for the Beck Depression Inventory–II. San Antonio: Psychological Corporation.Google Scholar
  6. Bylund, P. O., & Bjornstig, U. (1998). Sick leave and disability pension among passenger car occupants injured in urban traffic. Spine, 23, 1023–1028.CrossRefPubMedGoogle Scholar
  7. Cassidy, J. D., Carroll, L. J., Côté, P., Lemstra, M., Berglund, A., & Nygren, Å. (2000). Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. The New England Journal of Medicine, 342, 1179–1186.CrossRefPubMedGoogle Scholar
  8. Côté, P., Cassidy, J. D., Carroll, L., Frank, J. W., & Bombardier, C. (2001). A systematic review of the prognosis of acute whiplash and new conceptual framework to synthesize the literature. Spine, 26, E445–E458.CrossRefPubMedGoogle Scholar
  9. Crombez, G., Vlaeyen, J. W., Heuts, P. H., & Lysens, R. (1999). Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability. Pain, 80, 329–339.CrossRefPubMedGoogle Scholar
  10. Franche, R. L., & Krause, N. (2002). Readiness for return to work following injury or illness: Conceptualizing the interpersonal impact of health care, workplace, and insurance factors. Journal of Occupational Rehabilitation, 12, 233–256.CrossRefPubMedGoogle Scholar
  11. French, D., Roach, P., & Mayes, S. (2002). Peur du mouvement chez des accidentés du travail: l’Échelle de Kinésiophobie de Tampa (EKT). Canadian Journal of Behavioural Science, 34, 40–45.Google Scholar
  12. French, D., Noel, M., Vigneau, F., French, J., Chantal, P., & Evans, R. (2005). L’Échelle de dramatisation face à la douleur PCS-CF: Adaptation canadienne en langue française de l’échelle “Pain Catastrophizing Scale”. Canadian Journal of Behavioural Science, 37, 181–192.Google Scholar
  13. Garb, H. N. (1989). Clinical judgment, clinical training, and professional experience. Psychological Bulletin, 105, 387–396.CrossRefPubMedGoogle Scholar
  14. Gozzard, C., Bannister, G., Langkamer, G., Khan, S., Gargan, M., & Foy, C. (2001). Factors affecting employment after whiplash injury. Journal of Bone and Joint Surgery, 83, 506–509.CrossRefGoogle Scholar
  15. Harder, S., Veilleux, M., & Suissa, S. (1998). The effect of socio-demographic and crash-related factors on the prognosis of whiplash. Journal of Clinical Epidemiology, 51, 377–384.CrossRefPubMedGoogle Scholar
  16. Hendriks, E. J., Scholten-Peeters, G. G., van der Windt, D. A., Neeleman-van der Steen, C. W., Oostendorp, R. A., & Verhagen, A. P. (2005). Prognostic factors for poor recovery in acute whiplash patients. Pain, 114, 408–416.CrossRefPubMedGoogle Scholar
  17. Hole, D., Cook, J., & Bolton, J. (1995). Reliability and concurrent validity of two instruments for measuring cervical range of motion: Effects of age and gender. Manual Therapy, 1, 36–42.CrossRefPubMedGoogle Scholar
  18. Holm, L., Cassidy, J. D., Sjogren, Y., & Nygren, Å. (1999). Impairment and work disability due to whiplash injury following traffic collisions. Scandinavian Journal of Public Health, 27, 116–123.CrossRefPubMedGoogle Scholar
  19. Hoogendoorn, W. E., Bongers, P. M., de Vet, H. C., Ariens, G. A., van Mechelen, W., & Bouter, L. M. (2002). High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: Results of a prospective cohort study. Occupational and Environmental Medicine, 59, 323–328.CrossRefPubMedGoogle Scholar
  20. Kapoor, S., Shaw, W. S., Pransky, G., & Patterson, W. (2006). Initial patient and clinician expectations of return to work after acute onset of work-related low back pain. Journal of Occupational and Environmental Medicine, 48, 1173–1180.CrossRefPubMedGoogle Scholar
  21. Kasch, H., Bach, F. W., & Jensen, T. S. (2001). Handicap after acute whiplash injury. A 1-year prospective study of risk factors. Neurology, 56, 1637–1643.PubMedGoogle Scholar
  22. Kori, S., Miller, R., & Todd, D. (1990). Kinesiophobia: A new view of chronic pain behavior. Pain Management. pp 35-43.Google Scholar
  23. Meehl, P. E. (1954). Clinical versus statistical prediction: A theoretical analysis and review of the evidence. Minneapolis: University of Minnesota Press.CrossRefGoogle Scholar
  24. Morrow-Howell, N. (1994). The M word: Multicollinearity in multiple regression. Social Work Research, 18, 247–251.Google Scholar
  25. Scholten-Peeters, G. G., Bekkering, G. E., Verhagen, A. P., van der Windt, D. A., Lanser, K., Hendriks, E., et al. (2002). Clinical practice guidelines for the physiotherapy of patients with whiplash-associated disorders. Spine, 27, 412–422.CrossRefPubMedGoogle Scholar
  26. Scholten-Peeters, G. G., Verhagen, A. P., Bekkering, G. E., van der Windt, D. A., Barnsely, L., Oostendorp, R. A., et al. (2003). Prognostic factors of whiplash-associated disorders: A systematic review of prospective cohort studies. Pain, 104, 303–322.CrossRefPubMedGoogle Scholar
  27. Sterling, M., Jull, G., Vicenzino, B., Kenardy, J., & Darnell, R. (2005). Physical and psychological factors predict outcome following whiplash injury. Pain, 114, 141–148.CrossRefPubMedGoogle Scholar
  28. Suissa, S. (2003). Risk factors of poor prognosis after whiplash injury. Pain Research & Management, 8, 69–75.Google Scholar
  29. Sullivan, M. J. L., Bishop, S., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7, 524–532.CrossRefGoogle Scholar
  30. Sullivan, M. J. L., Stanish, W., Waite, H., Sullivan, M., & Tripp, D. A. (1998). Catastrophizing, pain, and disability among patients with soft-tissue injuries. Pain, 77, 253–260.CrossRefPubMedGoogle Scholar
  31. Sullivan, M. J. L., & Stanish, W. D. (2003). Psychologically based occupational rehabilitation: The pain-disability prevention program. The Clinical Journal of Pain, 19, 97–104.CrossRefPubMedGoogle Scholar
  32. Sullivan, M. J. L., Feuerstein, M., Gatchel, R., Linton, S. J., & Pransky, G. (2005). Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes. Journal of Occupational Rehabilitation, 15, 475–489.CrossRefPubMedGoogle Scholar
  33. Sullivan, M. J. L., Adams, H., Rhodenizer, T., & Stanish, W. D. (2006). A psychosocial risk factor-targeted intervention for the prevention of chronic pain and disability following whiplash injury. Physical Therapy, 86, 8–18.PubMedGoogle Scholar
  34. Sullivan, M. J. L., Adams, H., Horan, S., Mahar, D., Boland, D., & Gross, R. (2008). The role of perceived injustice in the experience of chronic pain and disability: Scale development and validation. Journal of Occupational Rehabilitation, 18, 249–261.CrossRefPubMedGoogle Scholar
  35. Sullivan, M. J. L., Davidson, N., Garfinkel, B., Siriapaipant, N., & Scott, W. (2009). Perceived injustice is associated with heightened pain behavior and disability in individuals with whiplash injuries. Psychological Injury and Law, 2, 238–247.CrossRefGoogle Scholar
  36. Teasell, R. W., & Bombardier, C. (2001). Employment-related factors in chronic pain and chronic pain disability. The Clinical Journal of Pain, 17, S39–S45.CrossRefPubMedGoogle Scholar
  37. Velozo, C. A., Lustman, P. J., Cole, D. M., Montag, J. A., & Eubanks, B. (1991). Prediction of return to work by rehabilitation professionals. Journal of Occupational Rehabilitation, 1, 271–280.CrossRefGoogle Scholar
  38. Vlaeyen, J. W., Kole-Snijders, A. M., Boeren, R. G., & van Eek, H. (1995). Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain, 62, 363–372.CrossRefPubMedGoogle Scholar
  39. Vowles, K. E., Gross, R. T., & Sorrell, J. T. (2004). Predicting work status following interdisciplinary treatment for chronic pain. European Journal of Pain, 8, 351–358.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC. 2010

Authors and Affiliations

  1. 1.Department of PsychologyMcGill UniversityMontréalCanada

Personalised recommendations