Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
Disabil Rehabil. 2012;34(19):1617-32. doi: 10.3109/09638288.2012.656791. Epub 2012 Apr 13.
To use quantitative data characterizing whiplash-associated disorder (WAD)-related pain beliefs over time to develop qualitative analysis exploring experiences informing these beliefs.
A mixed-method design was used. Quantitative and qualitative data were collected concurrently at baseline and 3 and 6 months postmotor vehicle collision. WAD-related pain beliefs were quantitatively measured in a sample of adults with acute WAD. A subgroup of participants participated in an interview after each survey. Descriptive statistics quantitatively characterized beliefs at each measurement. High or low scores from survey beliefs subscales informed the semistructured interview. The qualitative component explored experiences informing endorsement of beliefs reported on the surveys using a meaning-focused approach.
Adjunctive meaning informing endorsement of beliefs related to cure, control, emotions and mystery was achieved. Qualitative analysis revealed a meta-theme labeled restitution, representing a desire to be "fixed". Stigma also emerged as a potentially important contextual descriptor of WAD meaning.
Restitution was the dominant underlying pattern of belief endorsement. While this may be adaptive early after WAD, it is problematic for meaning construction later on. Based on contemporary views on pain, identification of this narrative is important as it represents an incompatibility in the conceptualization of pain between patient and provider.
利用定量数据描述随挥鞭样损伤相关障碍(WAD)相关疼痛信念随时间的变化,开展定性分析以探索影响这些信念的相关体验。
采用混合方法设计。在机动车事故后基线及 3 个月和 6 个月时同时收集定量和定性数据。采用问卷调查法对急性 WAD 成人样本进行 WAD 相关疼痛信念的定量测量。部分参与者在每次调查后接受访谈。在每个测量时间点,采用描述性统计对信念进行定量描述。调查信念子量表的高分或低分反映了半结构化访谈的信息。使用聚焦意义的方法,从调查中报告的信念的角度出发,对定性部分进行分析,探索影响信念的体验。
实现了与治疗、控制、情绪和神秘性相关的信念的附加意义的佐证。定性分析揭示了一个名为“恢复”的主导性信念主题,代表了“被修复”的愿望。耻辱感也作为 WAD 意义的一个潜在重要情境描述符出现。
恢复是信念支持的主导模式。虽然这在 WAD 后早期可能是适应性的,但对后期的意义构建来说却是有问题的。基于当代对疼痛的观点,识别这种叙述很重要,因为它代表了患者和提供者之间对疼痛的概念化存在不兼容性。