Center for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Aotearoa New Zealand.
Center for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, Aotearoa New Zealand; Elite Health and Performance, Brisbane, Australia.
Musculoskelet Sci Pract. 2024 Oct;73:103143. doi: 10.1016/j.msksp.2024.103143. Epub 2024 Jul 10.
Anterior shoulder dislocations have a high recurrence rate, often necessitating stabilizing surgery, with residual long-term fear of reinjury.
To explore patients' experiences of anterior shoulder dislocations in relation to their lives, well-being, fear of reinjury, and future perspectives.
Qualitative study.
We interviewed fourteen individuals (median age 27.5 yrs, range 21-40; two women) with traumatic anterior glenohumeral dislocation within 5 years, with or without past stabilizing surgery. We analysed data using Interpretive Description.
We constructed three main themes. (1) Downward wellness spiral: The injury shattered their lives, influencing their self-identity and -confidence. Sleep disturbances added to stress levels, loss, depression and grief. The re-injury risk could lead to social isolation. (2) Out of arm's reach: Recurrences led to frustration as the prior surgery and rehabilitation appeared to have been unsuccessful, having to start again. Support from healthcare providers and whānau/family was crucial to regain trust in the body. (3) Obligatory compromise: Over time, some individuals accepted the re-injury risk, learnt to heed warning signals, or compromised by avoiding specific social and recreational activities, changing their sports or to other roles in their preferred sport, and adapting work-related and daily tasks.
Participants described in-depth socio-emotional responses following shoulder dislocations. Most participants described an ongoing interplay between fear and confidence in their shoulder. Healthcare provider support and professional relationship, on-going shoulder-related strengthening, and risk mitigation strategies were important to facilitate and maintain confidence and self-efficacy, and to re-consider and adjust the participant's goals when needed.
复发性肩关节前脱位的发生率较高，常需手术稳定肩关节，且患者长期存在再次受伤的恐惧。
探讨患者肩关节前脱位对其生活、健康、再损伤恐惧和未来展望的影响。
定性研究。
我们采访了 14 名（平均年龄 27.5 岁，范围 21-40 岁；2 名女性）在 5 年内经历过创伤性盂肱关节前脱位的患者，其中部分患者有过稳定手术史。我们采用解释性描述对数据进行分析。
构建了 3 个主题。（1）下降的健康螺旋：损伤打破了他们的生活，影响了他们的自我认同和自信。睡眠障碍增加了压力、丧失感、抑郁和悲伤。再次受伤的风险可能导致社交孤立。（2）触不可及：复发让他们感到沮丧，因为先前的手术和康复似乎没有成功，需要重新开始。来自医疗保健提供者和家人的支持对重新获得对身体的信任至关重要。（3）强制性妥协：随着时间的推移，一些患者接受了再损伤的风险，学会了注意预警信号，或者通过避免特定的社交和娱乐活动、改变他们喜欢的运动或在运动中扮演其他角色、调整工作相关和日常任务来妥协。
参与者详细描述了肩脱位后的社会心理反应。大多数参与者描述了肩部恐惧和信心之间的持续相互作用。医疗保健提供者的支持和专业关系、持续的肩部相关强化以及风险缓解策略对于促进和维持信心和自我效能感非常重要，并在需要时重新考虑和调整参与者的目标。
