Leung Raymond, Malliaropoulos Nikolaos, Korakakis Vasileios, Padhiar Nat
5William Harvey Research Institute, Centre for Sports and Exercise, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK.
Sports and Exercise Medicine Clinic, Thessaloniki, Greece.
J Foot Ankle Res. 2018 Apr 5;11:11. doi: 10.1186/s13047-018-0254-5. eCollection 2018.
Extracorporeal shockwave therapy (ESWT) is used to manage different tendinopathies and appears to be effective in some tendinopathies but not others. The reasons for this are unclear. There is evidence that patient outcomes can be influenced by a patient-centred approach. There is therefore a need to qualitatively evaluate patient experiences for a treatment like ESWT where uncertainties exist. The aim of this study was to understand patients' overall perspective of ESWT to manage their tendinopathy.
A qualitative semi-structured face-to-face interview study design was used and the data was analysed thematically using 'Framework Analysis'.
Eleven participants that have had radial ESWT (rESWT) to treat a range of tendinopathies were recruited from a private London sports clinic and interviewed in person or via Skype™. Four main themes and 16 subthemes were identified. Subthemes included previous failed treatment, clinician factors, mechanisms of ESWT, positive aspects, negative aspects, responsibility over own health and perceived outcomes.
The participants understood the procedural aspects of rESWT, but were largely unaware of its mechanism of action and whether it was found to be effective for their condition or not. The participants felt that self-management measures were equally or more important than rESWT to help treat their tendinopathies. Recommendations would be for rESWT providers to offer patients written information, maintain continuity of care, address patients' expectations, feedback on progress, and encourage self-management measures such as activity modification.
体外冲击波疗法（ESWT）用于治疗不同的肌腱病，在某些肌腱病中似乎有效，但在其他肌腱病中则不然。其原因尚不清楚。有证据表明，以患者为中心的方法会影响患者的治疗结果。因此，对于像ESWT这样存在不确定性的治疗方法，有必要对患者的体验进行定性评估。本研究的目的是了解患者对ESWT治疗其肌腱病的总体看法。
采用定性半结构化面对面访谈研究设计，并使用“框架分析”对数据进行主题分析。
从伦敦一家私人运动诊所招募了11名接受过桡侧体外冲击波疗法（rESWT）治疗一系列肌腱病的参与者，并对他们进行了面对面或通过Skype™的访谈。确定了四个主要主题和16个子主题。子主题包括先前治疗失败、临床医生因素、ESWT的作用机制、积极方面、消极方面、对自身健康的责任以及感知到的结果。
参与者了解rESWT的操作流程，但大多不了解其作用机制，也不清楚它对自己的病情是否有效。参与者认为自我管理措施在帮助治疗肌腱病方面与rESWT同样重要或更为重要。建议rESWT治疗提供者为患者提供书面信息，保持护理的连续性，满足患者的期望，反馈进展情况，并鼓励采取自我管理措施，如调整活动。
