Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study.
From: Eur Spine J. 2009 Apr 3. [Epub ahead of print]
To determine the association between expectations to return to work and self-assessed recovery. Positive expectations predict better outcomes in many health conditions, but to date the relationship between expecting to return to work after traffic related whiplash associated disorders and actual recovery has not been reported. The authors assessed early expectations for return to work in a cohort of 2,335 individuals with traffic related whiplash injury to the neck. Using multivariable Cox proportional hazard analysis they assessed the association between return to work expectations and self perceived recovery during the first year following the event. After adjusting for the effects of sociodemographic characteristics, initial pain and symptoms, post-crash mood, prior health status and collision related factors, those who expected to return to work reported global recovery 42% more quickly than those who did not have positive expectations. Knowledge of return to work expectation provides an important prognostic tool to clinicians for recovery.
It was noted in J Rheumatol. 2009 Feb 17, Recovery in whiplash associated disorders; After adjusting for the effect of sociodemographic characteristics, post-crash symptoms and pain, prior health status and collision related factors, those who expected to get better soon recovered over 3 times as quickly as those who expected that they would never get better. Findings were similar for resolution of pain related limitations and resolution of neck pain intensity.
Furthermore, in PLoS Medicine. 2008 May 13;5(5):e105, Expectations for Recovery Important in the Prognosis of Whiplash Injuries; There was a dose response relationship between recovery expectations and disability. After controlling for severity of physical and mental symptoms, individuals who stated that they were less likely to make a full recovery, were more likely to have a high disability compared to individuals who stated that they were very likely to make a full recovery from whiplash injuries. Individuals’ expectations for recovery are important in prognosis, even after controlling for symptom severity.
It is evident that clinicians should assess these expectations in order to identify those patients at risk of chronic whiplash and promote positive recovery expectations. This should be documented, especially in cases where there is financial gain associated with poor recovery for both clinician and patient.
