‘Down to the person, the individual patient themselves’

A qualitative study of treatment decision‐making for shoulder pain

Bibliographic Data

ID19506591
AuthorsChristina R Maxwell (0000-0003-3425-9814, School of Allied Health, Faculty of Education and Health Science University of Limerick Limerick Ireland, corresponding author), Karen McCreesh (0000-0003-3702-7330, School of Allied Health, Faculty of Education and Health Science University of Limerick Limerick Ireland), Jon Salsberg (0000-0003-2010-3691, Health Research Institute, Faculty of Education and Health Science University of Limerick Limerick Ireland), Katie Robinson (0000-0003-1008-9857, School of Allied Health, Faculty of Education and Health Science University of Limerick Limerick Ireland)
Year2022
Volume25
Issue3
Pages1108-1117
Publication date2022-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.13464
PMID35290703
OpenAlexW4221120313
LanguageEN
Citations received6
References cited48

INTRODUCTION: Many inconsistencies have been identified in the translation of evidence-based treatment recommendations for musculoskeletal shoulder pain into healthcare services, with little known about factors influencing decision-making. The objective of this study was to explore the views and experiences of healthcare providers (HCPs) and people living with shoulder pain on treatment decision-making. METHODS: Adopting a qualitative design, purposeful sampling was employed to recruit 13 individuals with nonspecific musculoskeletal shoulder pain and 30 HCPs. Data were collected through 1:1 semi-structured interviews and analysed using an approach informed by Constructivist Grounded Theory. To facilitate analysis, two patient and public involvement (PPI) meetings were conducted. RESULTS: Most participants (69%) had shoulder pain of ≥1-year duration. Biomechanical beliefs about shoulder pain predominated and were heavily influential in decision-making for both patients and HCPs. Despite a consensus that therapeutic alliance facilitated decision-making, the extent of collaboration between HCPs and patients in treatment decision-making was rather limited. In addition to condition-specific factors, Individual patient characteristics and resources also influenced treatment decisions. CONCLUSION: Findings revealed the complexity of the decision-making process for both patients and HCPs, exposing substantial gaps between the reported views and experiences of participants and the principles of client-centred and evidence-based practice. There is a pressing need to enhance the translation of evidence-based knowledge into practice in this clinical area. PATIENT OR PUBLIC CONTRIBUTION: In line with a consultative approach to collaborative data analysis, a subgroup of participants attended two PPI meetings to provide commentary and feedback on preliminary findings

Constructivist grounded theory · Grounded theory · Health care · Knowledge management · Knowledge translation · MEDLINE · Patient participation · Physical therapy · Qualitative research · Theoretical sampling · Medicine · Musculoskeletal Disorders and Rehabilitation · Musculoskeletal pain and rehabilitation · Nursing · Psychology · Shoulder Injury and Treatment

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