Exploring the experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative study within the POWER pilot and feasibility trial

MARIA MOFFATT, Julia Wade, Nadine Foster, CHRIS LITTLEWOOD

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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.
Original languageEnglish
Article number102893
Pages (from-to)1-28
Number of pages28
JournalMusculoskeletal Science and Practice
Volume69
Issue numberFebruary 2024
Early online date5 Dec 2023
DOIs
Publication statusPublished - 29 Feb 2024

Keywords

  • Rotator cuff
  • surgery
  • patient experience
  • qualitative
  • Surgery
  • Patient experience
  • Qualitative

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