de Freitas Letícia Jonas, Hotta Gisele Harumi, Alaiti Rafael Krasic, Fukusawa Leandro, Palacios-Ceña Domingo, Oliveira Anamaria Siriani
Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Research, Technology, and Data Science Office, Grupo Superador, São Paulo, São Paulo, Brazil.
Phys Ther. 2024 Dec 6;104(12). doi: 10.1093/ptj/pzae132.
This descriptive qualitative study aimed to gain insights into the expectations of individuals with chronic shoulder pain and to investigate how different levels of disability may influence their beliefs and expectations regarding improvement.
This qualitative study utilized the Common Sense Model as its theoretical framework. Conducted within a public physical therapy clinic, individuals with chronic shoulder pain who were awaiting the initiation of the treatment were included. Participants, female and male (aged 30-69 years), were purposefully sampled. Thirty participants, categorized into 2 groups based on the Shoulder Pain and Disability Index (SPADI) scores, underwent semi-structured interviews. Group 1, lower SPADI scores (0-60), had 10 participants, and Group 2, higher SPADI scores (61-100), had 20 participants. Thematic analysis and inductive coding were employed to analyze the interviews.
Common themes emerged in both groups: the use of medical terms for understanding the diagnosis and the multidimensional impact of pain. The last 2 themes differed between groups. Notable differences included Group 1's focus on resources for pain relief and positive expectations with physical therapy, while Group 2 emphasized rest, religion as a resource for pain relief, and God's role in improvement.
These findings highlight the complexity of beliefs and expectations among patients with chronic shoulder pain. Individuals with greater disability often incorporated religious beliefs into their coping strategies, but they held lower recovery expectations and reported negative treatment experiences. These insights have implications for tailoring patient-centered care approaches.
This study underscores the need for health care providers to consider the multidimensionality of recovery expectations, which can significantly influence patient outcomes. Clinicians can reflect on this knowledge to optimize treatment strategies and improve patient prognosis.
本描述性定性研究旨在深入了解慢性肩痛患者的期望，并调查不同程度的残疾如何影响他们对改善的信念和期望。
本定性研究采用常识模型作为其理论框架。在一家公共物理治疗诊所内进行，纳入了等待开始治疗的慢性肩痛患者。参与者为年龄在30 - 69岁之间的男性和女性，采用目的抽样法。根据肩痛和残疾指数（SPADI）得分将30名参与者分为两组，进行半结构化访谈。第1组，SPADI得分较低（0 - 60），有10名参与者；第2组，SPADI得分较高（61 - 100），有20名参与者。采用主题分析和归纳编码对访谈进行分析。
两组出现了共同主题：使用医学术语理解诊断以及疼痛的多维度影响。最后两个主题在两组之间存在差异。显著差异包括第1组关注缓解疼痛的资源以及对物理治疗的积极期望，而第2组强调休息、将宗教作为缓解疼痛的资源以及上帝在改善中的作用。
这些发现凸显了慢性肩痛患者信念和期望的复杂性。残疾程度较高的个体通常将宗教信仰纳入其应对策略，但他们对康复的期望较低，并报告了负面的治疗经历。这些见解对制定以患者为中心的护理方法具有启示意义。
本研究强调了医疗保健提供者需要考虑康复期望的多维度性，这可能会显著影响患者的治疗结果。临床医生可以反思这些知识，以优化治疗策略并改善患者预后。
