Measuring the Impact of the French Version of the Whiplash Book
Condition: Whiplash Trauma
MeSH terms: Whiplash Injuries
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): Whiplash book
Intervention type(s): Behavioral
Observational model: Other
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        emergency physicians
      
Keywords: Emergency physician; Whiplash Book; Whiplash trauma; Fears; Beliefs