Coping in patients with chronic whiplash-associated disorders: A descriptive study

Objective: There are few studies of the way patients with chronic whiplash-associated disorders cope with pain and other aspects of the condition. This study analyses: (a) gender differences in coping strategies; (b) whether the patients can be sub-grouped based on their coping strategies and whether the sub-groups differ clinically; and (c) the relative importance of background variables, symptoms and coping for quality of life. Design: A descriptive study. Patients: A total of 275 consecutive chronic patients with whiplash-associated disorders referred to a university hospital. Methods: A questionnaire covering background data, pain in different regions, symptoms not directly related to pain, Beck depression inventory, a Coping Strategy Questionnaire, a Life Satisfaction checklist (LiSat-11), SF-36 Health Survey and EuroQol instrument. Results: Three groups of patients were identified with respect to coping. Whether or not active coping strategies were used had little influence on health-related quality of life. When regressing health-related quality of life items, the following regressors were the most important: degree of depression, number of not directly pain-related symptoms, and catastrophizing cognitions influenced by pain intensities. Conclusion: A mixture of symptoms (pain and depression) and coping (catastrophizing) seem to be interwoven and explain patients' health-related quality of life. These characteristics should be assessed when planning rehabilitation.