Daily stressors in patients with acute whiplash associated disorders

Abstract

Purpose: Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal. Method: A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis. Results: The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as “expected” as well as “disabling”. Most threatening stressors were related to work, driving and feelings/cognitions. Conclusions: The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.

Implications for Rehabilitation

• Little is known about the coping process in acute WAD. In particular, what constitutes the most frequent stressors as reported on a daily basis.

• This study shows that individuals with acute WAD experience stressors from a wide variety of areas in everyday life, not only pain.

• Early identification of individual and situation-specific stressors may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals in acute WAD.

Keywords::

• Coping
• daily assessments
• whiplash associated disorders

Declaration of Interest: This study was supported by Uppsala-Örebro Regional Research Council and the Faculty of Medicine at Uppsala University.