Abstract
Background: As waiting times for orthopaedic surgery increase, there have been calls to move from ‘waiting lists’ to ‘preparation lists’, to better prepare patients for surgery. In this context, a pilot randomised controlled trial (POWER) was conducted, comparing physiotherapist-led exercise to waiting-list control (usual care), for patients awaiting rotator cuff repair surgery. This qualitative study was integrated within the pilot trial.
Objectives:
●Explore experiences of adults awaiting rotator cuff repair surgery in the NHS
●Explore the acceptability of the physiotherapist-led exercise intervention
●Explore barriers and enablers to recruitment, retention, and adherence
Design: Integrated qualitative study with semi-structured telephone interviews
Methods: Adults awaiting rotator cuff repair, consenting to participate in the trial were eligible. Sampling was purposive regarding age, gender, randomised allocation, and hospital site. Interviews were audio-recorded and transcribed. Data were analysed using Reflexive Thematic Analysis.
Results: 20 participants were recruited (age range 49 to 81 years; 12 male, 10 randomised to physiotherapist-led exercise). Many participants were unable to recall their experiences of trial processes; nonetheless, three themes were identified from the data: experience of shoulder pain and pathway to treatment; communication and decision-making in the context of rotator cuff repair surgery; and experiences of the POWER physiotherapist-led exercise intervention and processes.
Conclusions: Patients experience significant burden due to shoulder pain. Their journey to surgery can be long, confusing, and associated with perceived abandonment. In a future trial, the intervention should offer opportunity for shared decision-making, optional exit from the surgical pathway, and an individualised exercise programme.
Objectives:
●Explore experiences of adults awaiting rotator cuff repair surgery in the NHS
●Explore the acceptability of the physiotherapist-led exercise intervention
●Explore barriers and enablers to recruitment, retention, and adherence
Design: Integrated qualitative study with semi-structured telephone interviews
Methods: Adults awaiting rotator cuff repair, consenting to participate in the trial were eligible. Sampling was purposive regarding age, gender, randomised allocation, and hospital site. Interviews were audio-recorded and transcribed. Data were analysed using Reflexive Thematic Analysis.
Results: 20 participants were recruited (age range 49 to 81 years; 12 male, 10 randomised to physiotherapist-led exercise). Many participants were unable to recall their experiences of trial processes; nonetheless, three themes were identified from the data: experience of shoulder pain and pathway to treatment; communication and decision-making in the context of rotator cuff repair surgery; and experiences of the POWER physiotherapist-led exercise intervention and processes.
Conclusions: Patients experience significant burden due to shoulder pain. Their journey to surgery can be long, confusing, and associated with perceived abandonment. In a future trial, the intervention should offer opportunity for shared decision-making, optional exit from the surgical pathway, and an individualised exercise programme.
| Original language | English |
|---|---|
| Article number | 102893 |
| Pages (from-to) | 1-28 |
| Number of pages | 28 |
| Journal | Musculoskeletal Science and Practice |
| Volume | 69 |
| Issue number | February 2024 |
| Early online date | 5 Dec 2023 |
| DOIs | |
| Publication status | Published - 29 Feb 2024 |
Keywords
- Rotator cuff
- surgery
- patient experience
- qualitative
- Surgery
- Patient experience
- Qualitative