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探索肌腱病患者的信念、认知与经历:定性研究的系统评价与元民族志研究

Exploring the Beliefs, Perceptions, and Experiences of Individuals With Tendinopathy: A Systematic Review and Meta-Ethnography of Qualitative Studies.

作者信息

Mesiha Mark S, Obst Steven J, Randall Samantha, Rebar Amanda L, Dittman Cassandra K, Heales Luke J

机构信息

Musculoskeletal Health and Rehabilitations Research Group, School of Health, Medical and Applied Sciences, College of Health and Exercise Science, Central Queensland University, Sydney, NSW 2000, Australia.

Musculoskeletal Health and Rehabilitations Research Group, School of Health, Medical and Applied Sciences, College of Health and Exercise Science, Central Queensland University, Bundaberg, QLD 4670, Australia.

出版信息

Phys Ther. 2025 Jul 1;105(7). doi: 10.1093/ptj/pzaf060.

Abstract

IMPORTANCE

This study systematically examines the effects of tendinopathy on patients' quality of life and investigates their experiences with rehabilitation.

OBJECTIVE

This study aimed to synthesize qualitative research exploring the beliefs, perceptions, and experiences of individuals living with tendinopathy by employing a systematic review with meta-ethnography.

DATA SOURCES

Studies were identified from 4 databases (CINAHL, EMBASE, Scopus, and ProQuest One Academic).

STUDY SELECTION

Studies were included if they utilized qualitative methods to investigate beliefs, perceptions, and/or experiences of participants with clinically diagnosed tendinopathy.

DATA EXTRACTION AND SYNTHESIS

Data synthesis was completed using the 7 phases of meta-ethnography and reported using the meta-ethnography reporting guidelines. Risk of bias was assessed using the Joanna Briggs Checklist for Qualitative Studies. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual).

MAIN OUTCOMES(S) AND MEASURE(S): Twenty-three studies were included (rotator cuff [n = 12]; Achilles [n = 6]; gluteal [n = 2]; lateral elbow [n = 2]; and mixed tendinopathies [n = 1]). Methodological quality of included studies varied. Moderate confidence in review findings 1 and 2 and high confidence in review finding 3.

RESULTS

Qualitative synthesis identified 3 themes: (1) I need to understand why my tendon hurts (participants wanted clarity regarding the cause of symptoms); (2) I want to fix my tendon, but I don't know how (participants had varied beliefs regarding optimal management and how to reduce their pain); and (3) I am uncertain whether my lifestyle will return to normal (participants felt frustrated with the negative impact that tendinopathy had on their life).

CONCLUSION AND RELEVANCE

This review provides insights into the lived experiences of individuals with tendinopathy. The review advocates for clearer communication and education regarding causes and optimal management of tendinopathy. Participants' varied beliefs and uncertainties about treatment efficacy suggest that health care providers consider individualized evidence-based guidance to improve patient outcomes.

摘要

重要性

本研究系统地考察了肌腱病对患者生活质量的影响,并调查了他们的康复经历。

目的

本研究旨在通过运用元民族志系统评价,综合探索肌腱病患者的信念、认知和经历的定性研究。

数据来源

从4个数据库(CINAHL、EMBASE、Scopus和ProQuest One Academic)中识别研究。

研究选择

如果研究采用定性方法来调查临床诊断为肌腱病的参与者的信念、认知和/或经历,则纳入该研究。

数据提取与综合

使用元民族志的7个阶段完成数据综合,并根据元民族志报告指南进行报告。使用乔安娜·布里格斯定性研究清单评估偏倚风险。使用定性研究综述证据的推荐分级评估、发展和评价信心(GRADE-CERQual)评估对研究结果的信心。

主要结局和测量指标

纳入了23项研究(肩袖肌腱病[n = 12];跟腱肌腱病[n = 6];臀肌肌腱病[n = 2];外侧肘肌腱病[n = 2];混合型肌腱病[n = 1])。纳入研究的方法学质量各不相同。对综述结果1和2的信心为中等,对综述结果3的信心为高。

结果

定性综合确定了3个主题:(1)我需要了解我的肌腱为什么疼(参与者希望明确症状的原因);(2)我想修复我的肌腱,但我不知道怎么做(参与者对最佳治疗方法以及如何减轻疼痛有不同的看法);(3)我不确定我的生活方式是否会恢复正常(参与者对肌腱病对他们生活的负面影响感到沮丧)。

结论与意义

本综述提供了对肌腱病患者生活经历的见解。该综述提倡就肌腱病的病因和最佳治疗方法进行更清晰的沟通和教育。参与者对治疗效果的不同看法和不确定性表明,医疗保健提供者应考虑提供个性化的循证指导,以改善患者的治疗结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f68/12212419/428a462712f0/pzaf060f1.jpg

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