Minns Lowe Catherine J, Moser Jane, Barker Karen
Physiotherapy Research Unit, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7HE, UK.
BMC Musculoskelet Disord. 2014 Jul 9;15:228. doi: 10.1186/1471-2474-15-228.
Rotator cuff tears are a common cause of shoulder pain. There is an absence of information about symptomatic rotator cuffs from the patients' perspective; this limits the information clinicians can share with patients and the information that patients can access via sources such as the internet. This study describes the experiences of people with a symptomatic rotator cuff, their symptoms, the impact upon their daily lives and the coping strategies utilised by study participants.
An interpretive phenomenological analysis approach was used. 20 participants of the UKUFF trial (The United Kingdom Rotator Cuff Surgery Trial) agreed to participate in in-depth semi-structured interviews about their experiences about living with a symptomatic rotator cuff tear. Interviews were digitally recorded and fully transcribed. Field notes, memos and a reflexive diary were used. Data was coded in accordance with interpretive phenomenological analysis. Peer review, code-recode audits and constant comparison of data, codes and categories occurred throughout.
The majority of patients described intense pain and severely disturbed sleep. Limited movement and reduced muscle strength were described by some participants. The predominantly adverse impact that a symptomatic rotator cuff tear had upon activities of daily living, leisure activities and occupation was described. The emotional and financial impact and impact upon caring roles were detailed. Coping strategies included attempting to carry on as normally as possible, accepting their condition, using their other arm, using analgesics, aids and adaptions.
Clinicians need to appreciate and understand the intensity and shocking nature of pain that may be experienced by participants with known rotator cuff tears and understand the detrimental impact tears can have upon all areas of patient's lives. Clinicians also need to be aware of the potential emotional impact caused by cuff tears and to ensure that patients needing help for conditions such as depression are speedily identified and provided with support, explanation and appropriate treatment.
肩袖撕裂是肩部疼痛的常见原因。从患者角度来看，缺乏有关有症状肩袖的信息；这限制了临床医生能够与患者分享的信息以及患者可通过互联网等渠道获取的信息。本研究描述了有症状肩袖患者的经历、他们的症状、对其日常生活的影响以及研究参与者所采用的应对策略。
采用解释现象学分析方法。英国肩袖手术试验（UKUFF试验）的20名参与者同意就他们有症状肩袖撕裂的生活经历参与深入的半结构化访谈。访谈进行数字录音并全文转录。使用了现场笔记、备忘录和反思日记。数据按照解释现象学分析进行编码。在整个过程中进行了同行评审、代码重新编码审核以及数据、代码和类别的持续比较。
大多数患者描述了剧烈疼痛和严重睡眠障碍。一些参与者描述了活动受限和肌肉力量下降。描述了有症状肩袖撕裂对日常生活活动、休闲活动和职业的主要不利影响。详细阐述了情感和经济影响以及对护理角色的影响。应对策略包括尽可能正常地继续生活、接受自身状况、使用另一只手臂、使用镇痛药、辅助器具和进行调整。
临床医生需要认识并理解已知肩袖撕裂的参与者可能经历的疼痛强度和令人震惊的性质，并了解撕裂对患者生活各个方面可能产生的不利影响。临床医生还需要意识到肩袖撕裂可能造成的潜在情感影响，并确保迅速识别出因诸如抑郁症等情况需要帮助的患者，并为其提供支持、解释和适当治疗。
