Baltov Petko, Côte Julie, Truchon Manon, Feldman Debbie Ehrmann
School of Rehabilitation, University of Montreal, Montreal, Canada.
Disabil Rehabil. 2008;30(25):1947-55. doi: 10.1080/09638280701791245.
Identify psychosocial and socio-demographic factors (measured prior to treatment) that were associated with post-treatment self-perceived pain and disability and two secondary outcomes: psychological distress, and return to work in patients undergoing multidisciplinary rehabilitation for chronic whiplash associated disorders (WAD).
Interviews were conducted with 28 patients with chronic WAD at entry to and completion of an intensive rehabilitation program, and a telephone interview was carried out three months later. Participants completed pain and disability, and psychological distress questionnaires, at baseline and at both follow-ups. They also completed psychosocial questionnaires and provided socio-demographic information. The effect of each of the independent variables on the outcomes was first evaluated by simple regressions, and then subsequently by multiple regression analysis.
Higher baseline pain and disability predicted higher pain and disability at both follow-ups (p < 0.001), and higher psychological distress at program completion (p = 0.003). Younger age (p = 0.028) and higher baseline psychological distress (p = 0.002) were associated with higher psychological distress three months post-rehabilitation. Greater social support at work was prognostic of return to work at program completion (p = 0.04).
Baseline pain and disability was the only factor that affected pain and disability post-rehabilitation. Psychosocial factors played a role in the prognosis of psychological distress and return to work.
确定（治疗前测量的）社会心理和社会人口学因素，这些因素与慢性挥鞭样损伤相关疾病（WAD）多学科康复患者的治疗后自我感知疼痛和残疾以及两个次要结果相关：心理困扰和重返工作岗位。
在28例慢性WAD患者进入强化康复计划时和完成时进行访谈，并在三个月后进行电话访谈。参与者在基线和两次随访时完成疼痛和残疾以及心理困扰问卷。他们还完成了社会心理问卷并提供了社会人口学信息。首先通过简单回归评估每个自变量对结果的影响，随后通过多元回归分析进行评估。
较高的基线疼痛和残疾预示着两次随访时较高的疼痛和残疾（p < 0.001），以及计划完成时较高的心理困扰（p = 0.003）。较年轻的年龄（p = 0.028）和较高的基线心理困扰（p = 0.002）与康复后三个月较高的心理困扰相关。工作中更大的社会支持是计划完成时重返工作岗位的预后因素（p = 0.04）。
基线疼痛和残疾是影响康复后疼痛和残疾的唯一因素。社会心理因素在心理困扰和重返工作岗位的预后中起作用。
