Whiplash Trauma Clinical Trial
Official title:
Measuring the Impact of the French Version of the Whiplash Book on Both Treatment Approach and Fears and Beliefs Among Emergency Physicians
Whiplash trauma and the resulting whiplash associated disorders have been the subject of
much attention in the scientific literature and remain a major public health problem.
The most commonly encountered symptoms are neck pain, headache, low back pain, shoulder
pain, as well as visual impairment. It is not unusual for neck pain to become chronic, and
when this occurs, there may be serious consequences on a social, professional and financial
level.
Even though the role of the initial episode should not be ignored, progression to chronic
pain is probably multifactorial and, like non-specific low back pain, psycho-social factors,
and in particular patient fears and belief, seem to play a relevant role, as do
environmental factors. The professional consensus is that it is useful to provide targeted
information at an early stage in whiplash settings in order to reduce mistaken fears and
beliefs. A preliminary study enabled the investigators to validate a French version of an
information booklet that draws on validated data from evidence-based medicine. The booklet
was "Le guide du coup de fouet cervical," the French version of The Whiplash Book. This
study showed that fears and beliefs were considerably high in a population without neck
problems who were working in hospitals. It also revealed that simply providing information
could help lessen them.
Management following whiplash injury can make use of the recommendations as published in the
literature. Healthcare professionals must reassure and educate their patients that
post-traumatic pain is normal, and that they need to remain active and maintain physical
activity in order to improve their prognosis.
Only very few studies have evaluated the adherence of physicians or healthcare professionals
to the guidelines and to ways of changing their approach to treatment.
The main aim of this study was to determine what fears and beliefs physicians have about the
consequences of whiplash. The secondary aim was to measure the impact of a validated
information booklet on emergency physicians' approach to management following a whiplash
injury.
Once each of the department heads and the different physicians concerned had given their
agreement to take part in the study, an initial questionnaire folder (containing the WBQ and
FABQ) was sent by email and by post to each of the physicians drawn by randomization. Upon
inclusion, demographic data was collected from the physicians (gender, age, place of
practice, and length of time in practice), as well as any personal or family history of neck
pain or whiplash. The physicians were also asked how often they encountered cases of
whiplash.
Information about knowledge of whiplash injury was also sought. This included continuing
medical training or recent reading (within the previous 3 years), and in particular
knowledge of the different severity grades established by the Quebec Task Force
classification, the radiologic recommendations of the Canadian C-Spine Rule, and lastly the
latest HAS recommendation on physical therapy in post-whiplash neck pain.
Once the first questionnaire folder had been completed, a second folder was then sent to all
physicians participating in the study. The intervention group was instructed to complete the
questionnaires at least 48 hours after the intervention that is, after reading the
information booklet.
The same items were included as in the initial folder, with an additional questionnaire
enabling the intervention group to qualitatively assess the information booklet. If there
was no response, reminders were sent by email, then by telephone, and lastly by post.
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