Department of Psychology, McGill University, 1205 Doctor Penfield Avenue, Montreal, QC, H3A1B1, Canada.
J Occup Rehabil. 2013 Dec;23(4):557-65. doi: 10.1007/s10926-013-9417-1.
Emerging evidence suggests that perceptions of injustice negatively impact return to work following whiplash injury. The Injustice Experiences Questionnaire (IEQ) is a recently developed measurement tool that may be used to assess injury-related perceptions of injustice following injury. To date, although research has supported the predictive validity of the IEQ, a clinical cut off for interpreting this measure has not been established. Increased support for the validity and clinical interpretation of the IEQ represents a first step towards identifying patients that might benefit from targeted intervention to mitigate the impact of perceived injustice.
The IEQ was completed by 103 whiplash-injured patients upon commencement and completion of a standardized multidisciplinary rehabilitation program. One year later, individuals reported on their employment activity, pain severity, and use of narcotics. A receiver operating characteristic (ROC) curve analysis was conducted to identify the post-treatment IEQ score that was optimally associated with unemployment status at the follow-up. Secondary ROC curve analyses examined IEQ scores best associated with high pain severity and narcotic use 1 year following treatment.
Results indicated that IEQ scores significantly discriminated individuals who returned and did not return to work at the follow-up. An IEQ score of 19 optimally identified participants in terms of follow-up employment status. IEQ scores at the end of treatment also discriminated individuals with high and low pain severity ratings and narcotic use status at the follow-up. Post-treatment IEQ scores of 18 and 20 optimally identified participants who had high pain severity ratings and who were using narcotics at the follow-up, respectively.
These results further support the validity of the IEQ and provide a guideline for its clinical interpretation in patients with persistent pain and disability following musculoskeletal injury. IEQ scores above the identified cut off may represent a barrier to work return and may warrant targeted intervention.
新出现的证据表明，不公正感会对挥鞭样损伤后的工作回归产生负面影响。不公正体验问卷（IEQ）是一种最近开发的测量工具，可用于评估损伤后与损伤相关的不公正感。迄今为止，尽管研究支持 IEQ 的预测效度，但尚未确定解释该测量值的临床截止值。增加对 IEQ 的有效性和临床解释的支持，是确定可能受益于有针对性干预以减轻感知不公正影响的患者的第一步。
103 名挥鞭样损伤患者在开始和完成标准化多学科康复计划时完成了 IEQ。一年后，个体报告了他们的就业活动、疼痛严重程度和使用麻醉剂的情况。进行了接收者操作特征（ROC）曲线分析，以确定与随访时失业状态最佳相关的治疗后 IEQ 得分。二次 ROC 曲线分析检查了与治疗后 1 年高疼痛严重程度和使用麻醉剂最佳相关的 IEQ 得分。
结果表明，IEQ 得分显著区分了在随访时返回和未返回工作的个体。IEQ 得分为 19 分可最佳识别随访时的就业状态。治疗结束时的 IEQ 得分也可区分高和低疼痛严重程度评分以及随访时使用麻醉剂的个体。治疗后 IEQ 得分 18 和 20 分别最佳识别出在随访时疼痛严重程度评分高和使用麻醉剂的参与者。
这些结果进一步支持了 IEQ 的有效性，并为其在肌肉骨骼损伤后持续疼痛和残疾患者中的临床解释提供了指导。IEQ 得分高于确定的截止值可能代表工作回归的障碍，可能需要有针对性的干预。
