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急性疾病认知是否会调节碰撞前福利与鞭打创伤后颈部疼痛或残疾之间的关联?一项前瞻性多中心队列研究。

Do Acute Illness Perceptions Moderate the Association of Pre-Collision Welfare Benefits and Later Neck Pain or Disability Following Whiplash Trauma? A Prospective Multicentre Cohort Study.

作者信息

Carstensen Tina B W, Ravn Sophie L, Andersen Tonny E, Sæther Solbjørg M M, Ørnbøl Eva, Wellnitz Kaare B, Kasch Helge, Frostholm Lisbeth

机构信息

Department of Functional Disorders, Aarhus University Hospital, 8200 Aarhus, Denmark.

Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark.

出版信息

J Clin Med. 2024 Nov 22;13(23):7072. doi: 10.3390/jcm13237072.

Abstract

: Whiplash trauma is a worldwide significant public health issue, with post-collision chronic pain and physical and mental disability; the prevalence of whiplash trauma in the Japanese general population is estimated at 1.2% and in the Danish general population the whiplash condition has been reported to be 2.9%. Pre-collision welfare benefits and illness perceptions have been found to predict poor recovery after whiplash trauma. In this study, we examined whether illness perceptions measured shortly post-collision moderated the effect of welfare benefits five years before the collision on neck pain and neck-related disability one-year post-collision. : Patients consulting emergency rooms or general practices with neck pain after acute whiplash trauma were invited to complete questionnaires during the week after the collision and at three and 12-months post-collision. Further, we obtained register data on the number of weeks on three types of welfare benefits (sick leave benefits, unemployment benefits, and social assistance benefits) for a five-year period before the collision. Multiple logistic regression was applied. : 740 patients were included. We did not find a significant moderating effect of illness perceptions on the association between pre-collision welfare benefits and chronic neck pain and related disability. However, there was a trend towards illness perceptions at baseline and at the three-month follow-up having a moderating effect on the relationship between long-term sick leave and neck pain one year after the whiplash collision. Regarding long-term sick leave, we might have overlooked a substantial moderating effect due to methodological matters and recommend a replication of this study on a larger sample, also focusing on other recovery outcomes.

摘要

挥鞭样创伤是一个全球范围内重大的公共卫生问题,会导致碰撞后慢性疼痛以及身心残疾;据估计,日本普通人群中挥鞭样创伤的患病率为1.2%,丹麦普通人群中挥鞭样损伤情况的报告患病率为2.9%。碰撞前的福利补助和疾病认知已被发现可预测挥鞭样创伤后恢复不佳。在本研究中,我们考察了碰撞后不久测量的疾病认知是否会调节碰撞前五年的福利补助对碰撞后一年颈部疼痛和颈部相关残疾的影响。

因急性挥鞭样创伤后颈部疼痛而到急诊室或全科诊所就诊的患者被邀请在碰撞后一周内以及碰撞后三个月和十二个月时完成问卷调查。此外,我们获取了碰撞前五年三种福利补助(病假补助、失业补助和社会救助补助)的周数登记数据。应用了多元逻辑回归分析。

共纳入740名患者。我们未发现疾病认知对碰撞前福利补助与慢性颈部疼痛及相关残疾之间的关联有显著的调节作用。然而,在基线和三个月随访时的疾病认知对挥鞭样碰撞后一年长期病假与颈部疼痛之间的关系有调节作用的趋势。关于长期病假,由于方法学问题,我们可能忽略了一个实质性的调节作用,建议在更大样本上重复本研究,同时也关注其他恢复结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4c7/11642158/791a7a4e6dc2/jcm-13-07072-g001.jpg

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