Long-term effect in ADL after an interdisciplinary rehabilitation programme for WAD patients: a mixed-method study for deeper understanding of participants’ programme experiences

Abstract

Purpose: To evaluate long-term effects in self-perceived occupational performance and satisfaction in Activities of Daily Living (ADL) for patients with Whiplash Associated Disorders (WAD) with chronic pain in an interdisciplinary rehabilitation programme, and investigate patients’ opinions of programme effects. Method: A mixed-method with sequential explanatory design was used. Fifty-three patients with WAD were followed-up 12 months after discharge. The Canadian Occupational Performance Measure was used to evaluate the change in ADL and the Multidimensional Pain Inventory for psychosocial functioning. Telephone interviews, based on five structured questions about the perceived impact of the rehabilitation programme, were made. Results: The 12-month follow-up showed significant ADL improvement (p < 0.001). There was less interference in daily activities due to pain (p < 0.01), and life control increased. More people were back to work. Interviews revealed the programme’s environment as strengthening and safe, and participants felt they were met with respect. Key success factors were to be treated with respect to being part of the social context and to obtain new knowledge. Conclusions: The interdisciplinary rehabilitation programme had initiated a process of change towards a more active life for the participants. They had found a new way of managing their lives. Despite the absence of pain reduction, they managed ADL in a better way, had more life control and returned to work to a higher degree.

Implications for Rehabilitation

• Chronic pain after WAD effects the entire life for many people.

• Long-term effects on activities of daily living, life control and work ability have shown positive results after an interdisciplinary rehabilitation programme based on behavioural and cognitive principles.

• The key success factors were to be treated with respect to being a part of a social context and to obtain new knowledge.

• Chronic
• life control
• self-efficacy
• whiplash associated disorder

Acknowledgements

The authors extend thanks to the Research and Development Council of the County of Södra Älvsborg for its financial support and to the statisticians Margareta Carlsson and Pernilla Larsman for their valuable help with statistics.