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Evaluation of an evidence based patient educational booklet for management of whiplash-associated disorders

McClune, T., Burton, A. Kim and Waddell, Gordon (2003) Evaluation of an evidence based patient educational booklet for management of whiplash-associated disorders. Emergency medicine journal, 20. pp. 514-517. ISSN 1472-0205

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Objectives: This study aimed to develop and evaluate an evidence based educational booklet on whiplash associated disorders.

Methods: A comprehensive review of the available scientific evidence produced a set of unambiguous patient centred messages that challenge unhelpful beliefs about whiplash and promote an active approach to recovery. These messages were incorporated into a novel booklet, which was then evaluated qualitatively for end user acceptability and its ability to impart the intended messages, and quantitatively for its ability to improve beliefs about whiplash and what to do about it. The subjects comprised people attending accident and emergency or manipulative practice with a whiplash associated disorder, along with a sample of workers without a whiplash associated disorder (n = 142).

Results: The qualitative results showed that the booklet was considered easy to read, understandable, believable, and conveyed its key messages. Quantitatively, it produced a substantial statistically significant improvement in beliefs about whiplash among accident and emergency patients (mean 6.5, 95% CI 3.9 to 9.1, p<0.001), and among workers (mean 9.4, 95% CI 7.9 to 10.9, p<0.001), but the shift in the more chronic manipulation patients was substantially smaller (mean 3.3, 95% CI 0.5 to 6.1, p<0.05).

Conclusions: A rigorously developed educational booklet on whiplash (The Whiplash Book) was found acceptable to patients, and capable of improving beliefs about whiplash and its management; it seems suitable for use in the accident and emergency environment, and for wider distribution at the population level. A randomised controlled trial would be required to determine whether it exerts an effect on behaviour and clinical outcomes

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Item Type: Article
Additional Information: © 2007 BMJ Publishing Group Ltd and the British Association for Accident and Emergency Medicine
Uncontrolled Keywords: health education patient whiplash
Subjects: R Medicine > R Medicine (General)
Schools: School of Human and Health Sciences
School of Human and Health Sciences > Centre for Applied Psychological Research
School of Human and Health Sciences > Centre for Health and Social Care Research
References: Suissa S, Harder S, Veilleux M. The relation between initial symptoms and signs and the prognosis of whiplash. Eur Spine J 2001;10:44–9. 2 Gargan MF, Bannister GC. The rate of recovery following whiplash injury. Eur Spine J 1994;3:162–4. 3 Galasko CS. The cost of whiplash associated disorders. In: Gunzburg R, Szpalski M, eds. Whiplash injuries: current concepts in prevention, diagnosis and treatment of the cervical whiplash syndrome. Philadelphia: Lippincott- Raven, 1998:283–90. 4 Maimaris C, Barnes MR, Allen MJ. Whiplash injuries of the neck: a retrospective study. Injury 1998;19:393–6. 5 Mayou R, Bryant B. Outcome of whiplash neck injury. Injury 1996;27:617–23. 6 Obelieniene D, Schrader H, Bovim G, et al. Pain after whiplash: a prospective controlled inception cohort study. J Neurol Neurosurg Psychiatry 1999;66:279–83. Virani SN, Ferrari R, Russell AS. Physician resistance to the late whiplash syndrome. J Rheumatol 2001;28:2096–9. 8 Cote P, Cassidy JD, Carroll L, et al. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2001;26:E445–58. 9 Gargan M, Bannister G, Main C, et al. The behavioural response to whiplash injury. J Bone Joint Surg 1997;79-B:523–6. 10 Cote P, Hogg-Johnson S, Cassidy JD, et al. The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claimclosure after whiplash. J Clin Epidemiol 2001;54:275–86. 11 Spitzer WO, Skovron ML, Salmi LR, et al. Scientific monograph of the Quebec Task Force on whiplash-associated disorders: redefining ‘‘whiplash’’ and its management. Spine 1995;20(suppl):8–73S. 12 Department of Health. The patient’s charter. London: HMSO, 1992. 13 Coulter A, Entwistle V, Gilbert D. Informing patients. An assessment of the quality of patient information materials. London: Kings Fund, 1998. 14 Coulter A. Evidence based patient information. BMJ 1998;317:225–6. 15 Burton AK, Waddell G, Burtt R, et al. Patient educational material in the management of low back pain in primary care. Bull Hosp Jt Dis 1996;55:138–41. 16 McClune T, Burton AK, Waddell G. Whiplash associated disorders: a review of the literature to guide patient information and advice. Emerg Med J 2002;19:499–506. 17 Roland M, Waddell G, Klaber-Moffett J, et al. The back book. Norwich: The Stationery Office, 1996 ( 18 Symonds TL, Burton AK, Tillotson KM, et al. Do attitudes and beliefs influence work loss due to low back trouble? Occup Med 1996;46:25–32. 19 Waddell G, Burton AK, McClune T. The whiplash book. Norwich: The Stationery Office, 2001 ( 20 Burton AK, Waddell G, Tillotson KM, et al. Information and advice to patients with back pain can have a positive effect: a randomized controlled trial of a novel educational booklet in primary care. Spine 1999;24:2484–91. 21 Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet 1993;342:1317–22.
Depositing User: Sara Taylor
Date Deposited: 22 Feb 2007
Last Modified: 28 Aug 2021 23:37


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