Reflecting on whiplash associated disorder through a QoL lens: an option to advance practice and research

Abstract

Purpose: To examine the constructs of quality of life (QoL) as applied to whiplash associated disorder (WAD), its current state of measurement and suggestions for future application. Method: Narrative literature review. Results: The burden of WAD on the healthcare system is substantive. Assessment of QoL issues for people with WAD may provide a broader understanding of the patient experience. No consistent framework for QoL in WAD has been adopted, nor has preference for any QoL instrument been established. Inconsistent use of terminology for what is being measured, and the measures themselves hamper clarity on the issue. Options for assessing QoL currently include a meaningful condition-specific scale that has not undergone sufficient psychometric evaluation (Whiplash Disability Questionnaire (WDQ), or generic scales with strong psychometric properties that have not undergone sufficient relevancy evaluation (e.g. SF-36, WHOQOL BREF). Generic measures can measure overlapping constructs including heath status, utility, health-related quality of life or generic QoL. The inter-relationships between these in WAD have not been defined. Conclusions: Given the impact of WAD on QoL, additional clarity on tools and approaches are needed. There is a need for research on the relevance and clinical measurement properties of available condition-specific and generic tools to define a preferred measurement approach in WAD.

Implications for Rehabilitation

• Whiplash associated disorder (WAD) results in physical and psychological dysfunction impacting on a persons quality of life (QoL).

• There is currently no framework or standard tool with which to evaluate QoL in people with WAD.

• Use of the Whiplash Disability Questionnaire and a generic QoL tool such as the WHOQOL BREF is proposed as a means for comprehensive evaluation of QoL in people with WAD.

Keywords::

• Neck pain
• outcomes
• quality of life
• whiplash

Declaration of Interest: Lisa Carlesso is supported by a Fredrick Banting and Charles Best Canada graduate scholarship − Doctoral award from the Canadian Institute of Health Research Institute. Dr. MacDermid and Dr. Walton report no declaration of interest.