Page Matthew J, O'Connor Denise A, Malek Mary, Haas Romi, Beaton Dorcas, Huang Hsiaomin, Ramiro Sofia, Richards Pamela, Voshaar Marieke J H, Shea Beverley, Verhagen Arianne P, Whittle Samuel L, van der Windt Danielle A, Gagnier Joel J, Buchbinder Rachelle
School of Public Health and Preventive Medicine, Monash University, Melbourne.
Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern.
Rheumatology (Oxford). 2019 Mar 6. doi: 10.1093/rheumatology/kez046.
To describe the experiences (including symptoms and perceived impacts on daily living) of people with a shoulder disorder.
Systematic review of qualitative studies. We searched for eligible qualitative studies indexed in Ovid MEDLINE, Ovid Embase, CINAHL (EBSCO), SportDiscus (EBSCO) and Ovid PsycINFO up until November 2017. Two authors independently screened studies for inclusion, appraised their methodological quality using the Critical Appraisal Skills Programme checklist, used thematic synthesis methods to generate themes describing the experiences reported by participants and assessed the confidence in the findings using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative research (GRADE-CERQual) approach.
The inclusion criteria were met by eight studies, which included 133 participants (49 females and 84 males) with either rotator cuff disease, adhesive capsulitis, proximal humeral fracture, shoulder instability or unspecified shoulder pain. We generated seven themes to describe what people in the included studies reported experiencing: pain; physical function/activity limitations; participation restriction; sleep disruption; cognitive dysfunction; emotional distress; and other pathophysiological manifestations (other than pain). There were interactions between the themes, with particular experiences impacting on others (e.g. pain leading to reduced activities and sleep disruption). Following grading of the evidence, we considered it likely that most of the review findings were a reasonable representation of the experiences of people with shoulder disorders.
Patients with shoulder disorders contend with considerable disruption to their life. The experiences described should be considered by researchers seeking to select the most appropriate outcomes to measure in clinical trials and other research studies in people with shoulder disorders.
描述肩部疾病患者的经历（包括症状以及对日常生活的感知影响）。
对定性研究进行系统综述。我们检索了截至2017年11月在Ovid MEDLINE、Ovid Embase、CINAHL（EBSCO）、SportDiscus（EBSCO）和Ovid PsycINFO中索引的符合条件的定性研究。两位作者独立筛选纳入研究，使用批判性评估技能计划清单评估其方法学质量，采用主题综合方法生成描述参与者报告经历的主题，并使用定性研究综述证据的推荐评估、发展和评价分级（GRADE - CERQual）方法评估研究结果的可信度。
八项研究符合纳入标准，其中包括133名参与者（49名女性和84名男性），患有肩袖疾病、粘连性关节囊炎、肱骨近端骨折、肩关节不稳定或未明确的肩部疼痛。我们生成了七个主题来描述纳入研究中的人们报告的经历：疼痛；身体功能/活动受限；参与受限；睡眠中断；认知功能障碍；情绪困扰；以及其他病理生理表现（除疼痛外）。各主题之间存在相互作用，特定经历会对其他方面产生影响（例如疼痛导致活动减少和睡眠中断）。在对证据进行分级后，我们认为该综述的大多数结果可能合理地反映了肩部疾病患者的经历。
肩部疾病患者的生活受到相当大的干扰。寻求选择最合适结局指标以在肩部疾病患者的临床试验和其他研究中进行测量的研究人员应考虑这些所描述的经历。
