Söderlund Anne, Nordgren Lena, Sterling Michele, Stålnacke Britt-Marie
Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden,
Center for Clinical Research Sörmland (CKFD), Uppsala University, Eskilstuna, Sweden.
J Pain Res. 2018 Jun 29;11:1263-1271. doi: 10.2147/JPR.S158807. eCollection 2018.
The aim of this study was to conduct a meta-synthesis to analyze qualitative research findings and thereby understand patients' experiences of whiplash-associated disorders (WAD) and the injury-recovery process.
A qualitative meta-synthesis, which is an interpretive integration of existing qualitative findings, was performed. The databases PubMed, PsychINFO, Scopus, and Web of Science were searched. The Critical Assessment Skills Programme was used to assess the quality of the included studies.
Four studies were included. The synthesis resulted in several codes, 6 categories, and 3 themes (distancing from normalcy, self-efficacy in controlling the life situation after the injury, and readjustment and acceptance) that described the participants' pain beliefs, their WAD-related life situation and their future expectations and acceptance. Changes in self-image were difficult to cope with and likely led to perceived stigmatization. Struggling with feelings of loss of control appeared to lead to low confidence and insecurity. Focusing on increasing knowledge and understanding the pain and its consequences were believed to lead to better strategies for handling the situation. Furthermore, recapturing life roles, including returning to work, was challenging, but an optimistic outlook reinforced symptom improvements and contributed to feelings of happiness.
The results of the present study provide a comprehensive understanding of patients' complex, multifaceted experiences of WAD, and the injury-recovery process. The findings can guide us in the development of new ways to evaluate and manage WAD. The results also indicate that a more patient-centered approach is needed to determine the depth and breadth of each patient's problems.
本研究旨在进行一项元综合分析,以分析定性研究结果,从而了解鞭打相关疾病(WAD)患者的经历以及损伤恢复过程。
进行了一项定性元综合分析,即对现有定性研究结果进行解释性整合。检索了PubMed、PsychINFO、Scopus和Web of Science数据库。使用批判性评估技能计划评估纳入研究的质量。
纳入了四项研究。综合分析得出了几个编码、6个类别和3个主题(与正常状态脱节、受伤后控制生活状况的自我效能感、重新调整与接受),这些描述了参与者的疼痛信念、与WAD相关的生活状况以及他们的未来期望和接受程度。自我形象的变化难以应对,可能导致被污名化的感觉。与失去控制感作斗争似乎会导致信心低落和不安全感。专注于增加知识并理解疼痛及其后果被认为会带来更好的应对策略。此外,重新承担生活角色,包括重返工作岗位,具有挑战性,但乐观的前景会加强症状改善并带来幸福感。
本研究结果全面了解了WAD患者复杂、多方面的经历以及损伤恢复过程。这些发现可为我们开发评估和管理WAD的新方法提供指导。结果还表明,需要采用更以患者为中心的方法来确定每个患者问题的深度和广度。