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Title: Associations between compensable injury, perceived fault and pain and disability 1 year after injury: a registry-based Australian cohort study.
Epworth Authors: Ponsford, Jennie
Other Authors: Giummarra, Melita
Baker, Katharine
Ioannou, Liane
Gwini, Stella
Arnold, Carolyn
Cameron, Peter
Gibson, Stephen
Keywords: Disability
Trauma and Stressor Related Disorders
Musculoskeletal Pain
Chronic Pain
Preventative Interventions
Traumatic Injury
Psychological Impacts of Pain and Injury
Compensable Injury
Non-Compensible Injury
Brief Pain Inventory
Glasgow Outcome Scale
EuroQol Five Dimensions Questionnaire
Pain Catastrophising Scale
Pain Self-Efficacy Questionnaire
Injustice Experience Questionnaire
Tampa Scale of Kinesiophobia
Rehabilitation, Mental Health and Chronic Pain, Epworth HealthCare, Richmond, Victoria, Australia.
Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
Issue Date: Oct-2017
Publisher: BMJ Journals
Citation: BMJ Open. 2017 Oct 5;7(10):e017350
Abstract: OBJECTIVES: Compensable injury increases the likelihood of having persistent pain after injury. Three-quarters of patients report chronic pain after traumatic injury, which is disabling for about one-third of patients. It is important to understand why these patients report disabling pain, in order to develop targeted preventative interventions. This study examined the experience of pain and disability, and investigated their sequential interrelationships with, catastrophising, kinesiophobia and self-efficacy 1 year after compensable and non-compensable injury. DESIGN: Observational registry-based cohort study. SETTING: Metropolitan Trauma Service in Melbourne, Victoria, Australia. PARTICIPANTS: Participants were recruited from the Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry. 732 patients were referred to the study, 82 could not be contacted or were ineligible, 217 declined and 433 participated (66.6% response rate). OUTCOME MEASURES: The Brief Pain Inventory, Glasgow Outcome Scale, EuroQol Five Dimensions questionnaire, Pain Catastrophising Scale, Pain Self-Efficacy Questionnaire, Injustice Experience Questionnaire and the Tampa Scale of Kinesiophobia. METHODS: Direct and indirect relationships (via psychological appraisals of pain/injury) between baseline characteristics (compensation, fault and injury characteristics) and pain severity, pain interference, health status and disability were examined with ordinal, linear and logistic regression, and mediation analyses. RESULTS: Injury severity, compensable injury and external fault attribution were consistently associated with moderate-to-severe pain, higher pain interference, poorer health status and moderate-to-severe disability. The association between compensable injury, or external fault attribution, and disability and health outcomes was mediated via pain self-efficacy and perceived injustice. CONCLUSIONS: Given that the associations between compensable injury, pain and disability was attributable to lower self-efficacy and higher perceptions of injustice, interventions targeting the psychological impacts of pain and injury may be especially necessary to improve long-term injury outcomes.
DOI: 10.1136/bmjopen-2017-017350
PubMed URL:
ISSN: 2044-6055
Journal Title: BMJ Open
Type: Journal Article
Affiliated Organisations: Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Institute for Safety, Compensation & Recovery Research, Monash University, Melbourne, Victoria, Australia.
Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.
School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia.
Academic Board of Anaesthesia & Perioperative Medicine, School of Medicine Nursing & HealthSciences, Monash University, Clayton, Victoria, Australia.
Type of Clinical Study or Trial: Cohort Study Observational Study
Appears in Collections:Mental Health
Pain Management

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