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Title: Traumatic injury and perceived injustice: Fault attributions matter in a "no-fault" compensation state.
Epworth Authors: Ponsford, Jennie
Other Authors: Ioannou, Liane
Cameron, Peter
Gibson, Stephen
Gabbe, Belinda
Jennings, Paul
Arnold, Carolyn
Gwini, Stella
Georgiou-Karistianis, Nellie
Giummarra, Melita
Keywords: Traumatic Injury
Feelings of Injustice
Perceived Injustice
Physical Wellbeing
Mental Wellbeing
Chronic Pain
Associated Factors
Pain-Related Characteristics
Compensation Status
Victorian Orthopedic Trauma Outcomes Registry
Victorian State Trauma Registry
Demongraphics Relationship
Injury Severity
Length of Stay
Lawyer Involvement
Health Outcomes
Pain Severity
Clinical Interventions
Hierarchical Linear Regression
Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
Issue Date: Jun-2017
Publisher: Public Library of Science
Citation: PLoS One. 2017 Jun 5;12(6):e0178894
Abstract: BACKGROUND: Traumatic injury can lead to loss, suffering and feelings of injustice. Previous research has shown that perceived injustice is associated with poorer physical and mental wellbeing in persons with chronic pain. This study aimed to identify the relative association between injury, compensation and pain-related characteristics and perceived injustice 12-months after traumatic injury. METHODS: 433 participants were recruited from the Victorian Orthopedic Trauma Outcomes Registry and Victorian State Trauma Registry, and completed questionnaires at 12-14 months after injury as part of an observational cohort study. Using hierarchical linear regression we examined the relationships between baseline demographics (sex, age, education, comorbidities), injury (injury severity, hospital length of stay), compensation (compensation status, fault, lawyer involvement), and health outcomes (SF-12) and perceived injustice. We then examined how much additional variance in perceived injustice was related to worse pain severity, interference, self-efficacy, catastrophizing, kinesiophobia or disability. RESULTS: Only a small portion of variance in perceived injustice was related to baseline demographics (especially education level), and injury severity. Attribution of fault to another, consulting a lawyer, health-related quality of life, disability and the severity of pain-related cognitions explained the majority of variance in perceived injustice. While univariate analyses showed that compensable injury led to higher perceptions of injustice, this did not remain significant when adjusting for all other factors, including fault attribution and consulting a lawyer. CONCLUSIONS: In addition to the "justice" aspects of traumatic injury, the health impacts of injury, emotional distress related to pain (catastrophizing), and the perceived impact of pain on activity (pain self-efficacy), had stronger associations with perceptions of injustice than either injury or pain severity. To attenuate the likelihood of poor recovery from injury, clinical interventions that support restoration of health-related quality of life, and adjustment to the impacts of trauma are needed.
DOI: 10.1371/journal.pone.0178894
PubMed URL:
ISSN: 1932-6203
Journal Title: PLoS ONE
Type: Journal Article
Affiliated Organisations: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.
National Ageing Research Institute, University of Melbourne, Parkville, Victoria, Australia.
Farr Institute @CIPHER, Swansea University Medical School, Swansea, Wales, United Kingdom.
Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia.
College of Health and Biomedicine, Victoria University, Footscray, Victoria, Australia.
Academic Board of Anaesthesia & Perioperative Medicine, School of Medicine Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia.
Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia.
Type of Clinical Study or Trial: Observational Study
Appears in Collections:Mental Health

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