Exploring patients’ experiences of the whiplash injury-recovery process – a meta-synthesis

Anne Söderlund,1 Lena Nordgren,2,3 Michele Sterling,4,5 Britt-Marie Stålnacke6–8 1Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; 2Center for Clinical Research Sörmland (CKFD), Uppsala University, Eskilstuna, Sweden; 3Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; 4Recover Injury Research Centre, NHMRC Centre of Research Excellence in Road Traffic Injury, The University of Queensland, Herston, QLD, Australia; 5Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia; 6Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Sweden; 7Department of Clinical Sciences, Karolinska Institute, Stockholm, Sweden; 8Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden Purpose: The aim of this study was to conduct a meta-synthesis to analyze qualitative research findings and thereby understand patients’ experiences of whiplash-associated disorders (WAD) and the injury-recovery process. Materials and methods: A qualitative meta-synthesis, which is an interpretive integration of existing qualitative findings, was performed. The databases PubMed, PsychINFO, Scopus, and Web of Science were searched. The Critical Assessment Skills Programme was used to assess the quality of the included studies. Results: Four studies were included. The synthesis resulted in several codes, 6 categories, and 3 themes (distancing from normalcy, self-efficacy in controlling the life situation after the injury, and readjustment and acceptance) that described the participants’ pain beliefs, their WAD-related life situation and their future expectations and acceptance. Changes in self-image were difficult to cope with and likely led to perceived stigmatization. Struggling with feelings of loss of control appeared to lead to low confidence and insecurity. Focusing on increasing knowledge and understanding the pain and its consequences were believed to lead to better strategies for handling the situation. Furthermore, recapturing life roles, including returning to work, was challenging, but an optimistic outlook reinforced symptom improvements and contributed to feelings of happiness. Conclusion: The results of the present study provide a comprehensive understanding of patients’ complex, multifaceted experiences of WAD, and the injury-recovery process. The findings can guide us in the development of new ways to evaluate and manage WAD. The results also indicate that a more patient-centered approach is needed to determine the depth and breadth of each patient’s problems. Keywords: whiplash-associated disorders, control, self-efficacy, happiness, life situatio