Center for General Practice, Aalborg University, Aalborg, Denmark.
Center for General Practice, Aalborg University, Aalborg, Denmark; Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
J Pain. 2022 Apr;23(4):577-594. doi: 10.1016/j.jpain.2021.10.006. Epub 2021 Oct 28.
Patient education is essential to enable rehabilitation and self-management of longstanding knee pain in adolescents. Currently, a lack of insights into the socio-cognitive processes governing adolescents' self-management remains an obstacle for enhancing treatment efficacy. This study developed a conceptual model for integrating adolescents' challenges and barriers into future treatments. We conducted semi-structured retrospective interviews with 14 young adults (age 21-25 years) with knee pain since adolescence (9 years mean duration). Temporal developments in participants' knee pain were captured through a memorization exercise. Data was analyzed via the General Inductive Approach. Themes were organized into a matrix, extracting a conceptual model, which was tested with eight new participants. The analysis identified seven themes. Further interpretation, via the matrix, organized these within a four-stage trajectory of; gaining awareness, knowledgeability, contextual application and reconceptualization, each with different challenges and dilemmas, participants had to overcome to progress their self-management. Testing the conceptual model, confirmed stages and highlighted acceptance as key to overcoming barriers. The study described adolescents' integration of self-management as proximal and inquiry-based, with acceptance, driving increasingly complex management behaviors. We hypothesize future interventions may benefit from exploring supporting adolescents' inquiries into their knee pain at different stages of the trajectory. PERSPECTIVE: This study presents a conceptual model and vocabulary for optimizing patient education concepts, to target the challenges, barriers and needs of adolescents with knee pain at different stages of their mastery journey. We believe our findings may inform reflections among clinicians and researchers, and development of more effective education interventions.
患者教育对于实现青少年长期膝关节疼痛的康复和自我管理至关重要。目前，对于影响青少年自我管理的社会认知过程缺乏深入了解，这仍然是提高治疗效果的障碍。本研究开发了一个概念模型，将青少年的挑战和障碍纳入未来的治疗中。我们对 14 名患有青少年膝关节疼痛（平均患病时长 9 年）的年轻成年人（年龄 21-25 岁）进行了半结构化的回顾性访谈。通过记忆练习捕捉参与者膝关节疼痛的时间发展。通过一般归纳法进行数据分析。主题被组织到一个矩阵中，提取出一个概念模型，并用 8 名新参与者进行了测试。分析确定了七个主题。通过矩阵进一步解释，将这些主题组织在一个四个阶段的轨迹中：意识的获得、知识的获得、情境的应用和概念的重新构建，每个阶段都有不同的挑战和困境，参与者必须克服这些挑战才能推进自我管理。测试概念模型，证实了阶段，并强调了接受是克服障碍的关键。该研究描述了青少年将自我管理整合为一种基于探究的近端管理方式，接受是推动越来越复杂的管理行为的关键。我们假设未来的干预措施可能会受益于在轨迹的不同阶段探索支持青少年对其膝关节疼痛的探究。观点：本研究提出了一个概念模型和词汇，用于优化患者教育理念，以针对不同阶段的青少年膝关节疼痛患者的挑战、障碍和需求。我们相信，我们的研究结果可能会为临床医生和研究人员提供反思，并为开发更有效的教育干预措施提供信息。
