11/1/2011 Empowerment of personal injury victims Empowerment of - - PDF document

11/1/2011 1

Empowerment of personal injury victims

E- health Applied to Personal Injury Victims in Claims Settlement

Nieke Elbers A Akk Arno Akkermans Pim Cuijpers David Bruinvels

VU University Amsterdam

Empowerment of personal injury victims

Outline

• 1. Introduction
• 2. Intervention
• 3. Method
• 4. Results
• 5. Conclusion

Empowerment of personal injury victims

• 1. Introduction

Traffic accident victims claiming compensation have worse recovery than those not claiming compensation Secondary gain

• Secondary gain

Claiming compensation creates unconscious incentive not to get better

• Secondary victimization

Renewed victimization caused by claims settlement process

Empowerment of personal injury victims

• 2. Intervention

Interactive website (e-health): 1) Information 2) E-coach 3) Frequently Asked Questions

Empowerment of personal injury victims

• 2. Intervention

Information module:

• Claims settlement process

Assessment of

• Lawyer
• Opposite party (insurance company of wrongdoer)
• Social security
• Conflict resolution

Assessment of liability Medical assessment Assessment of earning capacity & rehabilitation Assessment

• f damages

Empowerment of personal injury victims

• 2. Intervention

E-coach module:

• Problem Solving Therapy
• 5 weekly lessons

Reading examples assignments

• Reading, examples, assignments
• Feedback
• Proven to be effective with different target populations
• New population: personal injury victims

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Empowerment of personal injury victims

• 2. Intervention

Validation website:

• Focus group

5 insurance companies (defendants) and 6 lawyers (plaintiffs) 5 insurance companies (defendants) and 6 lawyers (plaintiffs)

• Pilot

8 traffic accident victims

Empowerment of personal injury victims

• 3. Method

Participants:

• Traffic accident victims (n=170)
• Accident < 2 years ago
• Age > 18 years old

Procedure:

Empowerment of personal injury victims

• 4. Results

All (n=172) Intervention (n=85) Control (n=87) P-value Age (years)

48.7 ± 14.7 49.0 ± 15.0 48.5 ± 14.5 .80

Male (%)

54 51 58 .37

Injured body part (%)

Baseline independent variables

j y p ( )

Shoulder, arm, hand

52 49 54 .55

Head or neck

49 51 48 .76

Hip, leg, foot

49 45 54 .22

Trunk or back

31 37 25 .11

Hospitalization (%)

42 39 46 .35

If yes, how many days

9.4 ± 11.0 11.2 ± 12.7 8.0 ± 9.3 .22

Whiplash (%)

31 35 28 .28

Empowerment of personal injury victims

• 4. Results

Baseline dependent variables

3,5 4 4,5 5 0‐1 year old 1‐2 years old n(0-1) = 92 1 1,5 2 2,5 3 Empowerment Depression Anxiety Somatic symptoms

p = .02

n(0 1) 92 n(1-2) = 80

Empowerment of personal injury victims

• 4. Results

6 7 8 9 10 0-1 year old 1-2 years old

p = .05

n(0-1) = 92 1 2 3 4 5 6 Self efficacy Quality of life Work ability Burden n(0 1) 92 n(1-2) = 80

Empowerment of personal injury victims

• 4. Results

Website usage:

• Baseline  3 months (n=59)

Login at least one time Login not once

61% Information module:

Page views: 9 ± 7

E-coach module:

None!

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Empowerment of personal injury victims

• 5. Conclusion
• Participants longer involved in compensation

feel worse than participants just involved in compensation  Strengths: placebo control (instead of waiting list control) and l l f d pragmatic, real life conditions − Limitation: Limited generalization to PI victims in general and to countries with different claims settlement processes

• First e-health intervention in the field of (liability) law:

unexplored research area with a lot of potential

Empowerment of personal injury victims

Thank you

Contact information: Nieke Elbers n.elbers@vu.nl