School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Br J Sports Med. 2020 Jul;54(14):858-865. doi: 10.1136/bjsports-2019-101281. Epub 2020 Jan 24.
Clinicians who use the biopsychosocial approach to manage musculoskeletal pain disorders aim to understand how patients make sense of their symptoms. Treatment includes targeting the negative beliefs and coping responses that can lead to progressive pain and disability. We aimed to explore how people seeking care for persistent hip pain and disability make sense of their symptoms.
Cross-sectional qualitative study. People were eligible if they were aged ≥18 years, were consulting an orthopaedic surgeon for persistent hip pain and offered a non-surgical intervention. Data were collected through interviews that explored patients' beliefs about the identity (diagnosis), causes, consequences, timeline and controllability of their symptoms, their strategies to cope with pain and their experiences in seeking healthcare. Transcribed interview data were analysed thematically using a framework approach.
Sixteen people (median age=51, range=33-73 years; median duration hip pain=3 years, range=3 months-20 years) participated. Most participants (10/16) believed their pain was caused by an exercise-related injury. Because of the results of imaging and interactions with healthcare professionals, all participants believed they had damaged hip structures. All described ineffective strategies to manage their pain and multiple failed treatments. For many (7/16), a lack of control over symptoms threatened their physical and mental health.
The way participants with persistent hip pain and disability made sense of their symptoms contributed to them avoiding physical activity, and it impaired their sleep, emotional well-being and physical health.
采用生物-心理-社会方法治疗肌肉骨骼疼痛障碍的临床医生旨在了解患者如何理解自己的症状。治疗包括针对可能导致疼痛加重和残疾的负面信念和应对反应。我们旨在探讨寻求持续髋部疼痛和残疾治疗的人如何理解他们的症状。
横断面定性研究。参与者符合以下条件：年龄≥18 岁，因持续性髋部疼痛咨询骨科医生并提供非手术干预。通过访谈收集数据，探讨患者对症状的身份（诊断）、原因、后果、时间进程和可控制性、应对疼痛的策略以及在寻求医疗保健方面的经历的信念。使用框架方法对转录的访谈数据进行主题分析。
16 人（中位数年龄=51 岁，范围 33-73 岁；中位数髋部疼痛持续时间=3 年，范围 3 个月-20 年）参与了研究。大多数参与者（10/16）认为他们的疼痛是由与运动相关的损伤引起的。由于影像学结果和与医疗保健专业人员的互动，所有参与者都认为他们的髋部结构受损。所有人都描述了管理疼痛的无效策略和多次失败的治疗。对许多人（7/16）来说，对症状的控制不足威胁到他们的身心健康。
持续髋部疼痛和残疾的患者对其症状的理解方式导致他们避免体力活动，影响睡眠、情绪健康和身体健康。
