Faculty of Health Sciences, University of Southampton, 12 University Road, Southampton, SO17 1BJ, UK.
Musculoskelet Sci Pract. 2018 Feb;33:71-76. doi: 10.1016/j.msksp.2017.11.005. Epub 2017 Nov 21.
Clinical guidelines recommend that investigations, such as magnetic resonance imaging, are offered only when likely to change management. Meanwhile, the optimal process of diagnosing radiculopathy remains uncertain and, in clinical practice, differences of opinion can occur between patient and clinician regarding the perceived importance of investigations.
To explore peoples' experiences of investigations and the effect of concordance between clinical presentation and investigation findings.
In this qualitative study, 14 participants who had recently undergone investigations for a clinical presentation of radiculopathy were purposively recruited from an NHS, Primary Care Service in the United Kingdom. Based on the principles of interpretative phenomenological analysis, individual, semi-structured interviews were recorded and transcribed verbatim. Data were managed using a framework approach and analysed thematically.
Although people reported wanting investigations to understand the cause of symptoms and inform management, access to them was reported to be difficult and protracted. When investigations revealed potentially relevant findings, people experienced relief, validation, empowerment and decisive decision-making. Disappointment emerged, however, regarding treatment options and waiting times, and long-term prognosis. When investigations failed to identify relevant findings, people were unable to make sense of their symptoms, relinquish their search to identify the cause, or to move forward in their management.
This study provides the first reported in-depth interpretation of peoples' experience of undergoing investigations specifically for radiculopathy. Important implications have been identified for: investigation referral criteria; shared-decision-making; information sharing and managing expectations and disappointment. CLINICALTRIALS.
UOS-2307-CR.
临床指南建议仅在可能改变治疗方案的情况下提供磁共振成像等检查。然而，神经根病的最佳诊断流程仍不确定，在临床实践中，患者和临床医生可能对检查的重要性存在不同意见。
探讨人们对检查的体验，以及检查结果与临床表现是否一致的影响。
本定性研究从英国国民保健署（NHS）初级保健服务中选择了 14 名最近因神经根病的临床表现接受过检查的参与者进行了有针对性的招募。根据解释现象学分析的原则，对参与者进行了个体半结构化访谈，并逐字记录和转录。使用框架方法管理数据，并进行主题分析。
尽管人们表示希望通过检查了解症状的原因并为治疗提供依据，但他们发现获得这些检查的机会很困难且耗时漫长。当检查结果显示出潜在相关发现时，人们会感到宽慰、得到证实、获得力量并做出果断的决策。然而，当治疗方案和等待时间以及长期预后不尽如人意时，人们会感到失望。当检查未能发现相关发现时，人们无法理解自己的症状，无法放弃寻找病因的努力，或者无法在治疗过程中取得进展。
本研究首次深入解读了人们专门因神经根病接受检查的体验。这对检查转诊标准、共同决策、信息共享以及管理期望和失望感具有重要意义。临床试验.gov 注册号：UOS-2307-CR。
