van der Meer Suzan, Pieterse Marcel, Reneman Michiel, Verhoeven Jan, van der Palen Job
a Department of Research Methodology , Measurement and Data Analysis, University Twente , Enschede , the Netherlands .
b Department of Physical Activity and Health , Saxion University of Applied Sciences , Enschede , The Netherlands .
Disabil Rehabil. 2016;38(3):211-7. doi: 10.3109/09638288.2015.1035455. Epub 2015 Apr 14.
To explore rehabilitation professionals' opinions about the influence and the pathways of injury compensation (IC) on health and disability in patients with whiplash associated disorder (WAD).
Semi-structured interviews were performed among a purposeful selected sample of Dutch expert-professionals in the field of rehabilitation of patients with WAD. Inclusion continued until saturation was reached. Inductive and deductive thematic analyses were performed.
Ten rehabilitation expert-professionals (five females), working as physician, psychologist or physiotherapist, were interviewed. All expert-professionals acknowledged that IC can influence rehabilitation, health and disability. The expert-professionals provided three causal pathways; a pathway through prolonged distress, a behavioral pathway, and patient characteristics that may either attenuate or worsen their response. They assess the influence of IC mainly with interview techniques. Most professionals discuss the potential influence of IC with their patients, because they want to give clear information to the patient. Some emphasize that their role is neutral in relation with the IC. Others mention that financial consequences can accompany functional improvement.
Rehabilitation expert-professionals believe that IC may affect rehabilitation, health and disability in patients with WAD. Three pathways are mentioned by the experts-professionals.
According to rehabilitation expert-professionals, an injury compensation (IC) can lead to distress, by creating a (conscious or unconscious) conflict of interests within a patient between striving for compensation on one hand, and recovery on the other hand. Patient characteristics can either attenuate or worsen IC-related distress. Reliable and valid tools need to be developed to assess the influence of IC on health, disability and rehabilitation, and to limit the negative effects. Rehabilitation professionals can discuss the possible unintended effects of IC with their patients to clarify their current situation.
探讨康复专业人员对于损伤赔偿（IC）对挥鞭样相关疾病（WAD）患者的健康和残疾状况的影响及途径的看法。
对有目的地选取的荷兰WAD患者康复领域专家专业人员样本进行半结构式访谈。持续纳入直至达到饱和状态。进行归纳和演绎主题分析。
对10名担任医生、心理学家或物理治疗师的康复专家专业人员（5名女性）进行了访谈。所有专家专业人员都承认IC会影响康复、健康和残疾状况。专家专业人员提供了三条因果途径：一条通过长期痛苦的途径、一条行为途径以及可能减轻或加重其反应的患者特征。他们主要通过访谈技巧评估IC的影响。大多数专业人员会与患者讨论IC的潜在影响，因为他们想向患者提供明确信息。一些人强调他们在IC方面的角色是中立的。其他人提到功能改善可能会带来经济后果。
康复专家专业人员认为IC可能会影响WAD患者的康复、健康和残疾状况。专家专业人员提到了三条途径。
根据康复专家专业人员的说法，损伤赔偿（IC）可能会导致痛苦，因为它在患者内部造成了（有意识或无意识的）利益冲突，一方面是争取赔偿，另一方面是康复。患者特征可能会减轻或加重与IC相关的痛苦。需要开发可靠且有效的工具来评估IC对健康、残疾和康复的影响，并限制其负面影响。康复专业人员可以与患者讨论IC可能产生的意外影响，以阐明他们当前的状况。
