Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia.
Centre for Organisational and Social Informatics, Faculty of Information Technology, Monash University, Victoria, Australia.
Disabil Rehabil. 2022 Jul;44(14):3686-3693. doi: 10.1080/09638288.2021.1879945. Epub 2021 Feb 12.
Rotator cuff related shoulder pain (RCRSP) is a common and disabling shoulder condition and surgical management is becoming more common. The rates and costs of surgical interventions have been on the rise. Understanding decision-making related to surgery and providing adequate information to people with RCRSP may improve patient-centred care and potentially reduce rates of surgery.
To explore the decision-making processors of people who have undertaken surgery for RCRSP.
An in-depth thematic analysis.
Interviews were conducted with patients from Melbourne who had had surgical management for RCRSP. Data were analysed using an inductive thematic approach.
Fifteen participants were recruited. Six key themes emerged: (1) Needing to get it done: "It was necessary to remedy the dire situation"; (2) Non-surgical treatment experience:" I knew that I'd done all I could"; (3) Mechanical problem:" Physio's not going to repair a torn tendon"; (4) Trust in medical professionals "If they told me that I needed to swallow a thousand spiders, I would have done it."; (5) Varied information sources "Dr Google played a big part in it"; (6) Organisational barriers "It was absolutely useless, my insurance."
Surgery appears to be commonly precipitated by unremitted severe symptoms and failed non-surgical treatment. While there was strong trust in highly trained surgeons, decision to undergo surgery also drew on questionable pathoanatomical beliefs and instances of inadequate patient information about treatment choices and risks that may be addressed by adopting a more patient-centred care approach.IMPLICATIONS FOR REHABILITATIONUnderstanding decision-making related to surgery and providing adequate information to people with rotator cuff related shoulder pain may improve patient-centred care.Surgery appears to be commonly precipitated by unremitted severe symptoms and failed non-surgical treatment.Decision to undergo surgery sometimes drew on questionable pathoanatomical beliefs.There was strong trust in highly trained surgeons but there were instances of inadequate patient information about treatment choices and risks.
肩袖相关的肩部疼痛（RCRSP）是一种常见且使人丧失能力的肩部疾病，手术治疗变得越来越普遍。手术干预的比率和成本一直在上升。了解与手术相关的决策过程，并向 RCRSP 患者提供足够的信息，可能会改善以患者为中心的护理，并有可能降低手术率。
探讨接受 RCRSP 手术治疗的患者的决策过程。
深入的主题分析。
对来自墨尔本的接受过 RCRSP 手术治疗的患者进行访谈。使用归纳主题分析方法对数据进行分析。
共招募了 15 名参与者。出现了 6 个主要主题：（1）需要解决：“必须解决这种可怕的情况”；（2）非手术治疗经历：“我知道我已经尽力了”；（3）机械问题：“物理治疗师无法修复撕裂的肌腱”；（4）对医疗专业人员的信任：“如果他们告诉我需要吞下一千只蜘蛛，我也会照做”；（5）不同的信息来源：“谷歌医生在其中发挥了重要作用”；（6）组织障碍：“这完全没用，我的保险。”
手术似乎通常是由未缓解的严重症状和非手术治疗失败引起的。虽然对高技能的外科医生有很强的信任，但手术决策也依赖于有问题的病理解剖学信念，以及对治疗选择和风险的信息不足，这可能通过采用更以患者为中心的护理方法来解决。
了解与手术相关的决策过程并向肩袖相关肩部疼痛患者提供足够的信息，可能会改善以患者为中心的护理。手术似乎通常是由未缓解的严重症状和非手术治疗失败引起的。手术决策有时依赖于有问题的病理解剖学信念。虽然对高技能的外科医生有很强的信任，但也有一些情况下，患者对治疗选择和风险的信息不足。
