Abstract
Background
As waiting times for orthopaedic surgery increase, there have been calls to move from ‘waiting lists’ to ‘preparation lists’, to better prepare patients for surgery. In this context, a pilot randomised controlled trial (POWER) was conducted, comparing physiotherapist-led exercise to waiting-list control (usual care), for patients awaiting rotator cuff repair surgery. This qualitative study was integrated within the pilot trial.
Objectives
Explore the experiences of adults awaiting rotator cuff repair surgery in the NHS.
Explore the acceptability of the physiotherapist-led exercise intervention.
Explore the barriers and enablers to recruitment, retention, and adherence.
Design
Integrated qualitative study with semi-structured telephone interviews.
Methods
Adults awaiting rotator cuff repair, consenting to participate in the trial were eligible. Sampling was purposive regarding age, gender, randomised allocation, and hospital site. Interviews were audio-recorded and transcribed. Data were analysed using Reflexive Thematic Analysis.
Results
20 participants were recruited (age range 49–81 years; 12 male, 10 randomised to physiotherapist-led exercise). Many participants were unable to recall their experiences of trial processes; nonetheless, three themes were identified from the data: experience of shoulder pain and pathway to treatment; communication and decision-making in the context of rotator cuff repair surgery; and experiences of the POWER physiotherapist-led exercise intervention and processes.
Conclusions
Patients experience significant burden due to shoulder pain. Their journey to surgery can be long, confusing, and associated with perceived abandonment. In a future trial, the intervention should offer opportunity for shared decision-making, optional exit from the surgical pathway, and an individualised exercise programme.
As waiting times for orthopaedic surgery increase, there have been calls to move from ‘waiting lists’ to ‘preparation lists’, to better prepare patients for surgery. In this context, a pilot randomised controlled trial (POWER) was conducted, comparing physiotherapist-led exercise to waiting-list control (usual care), for patients awaiting rotator cuff repair surgery. This qualitative study was integrated within the pilot trial.
Objectives
Explore the experiences of adults awaiting rotator cuff repair surgery in the NHS.
Explore the acceptability of the physiotherapist-led exercise intervention.
Explore the barriers and enablers to recruitment, retention, and adherence.
Design
Integrated qualitative study with semi-structured telephone interviews.
Methods
Adults awaiting rotator cuff repair, consenting to participate in the trial were eligible. Sampling was purposive regarding age, gender, randomised allocation, and hospital site. Interviews were audio-recorded and transcribed. Data were analysed using Reflexive Thematic Analysis.
Results
20 participants were recruited (age range 49–81 years; 12 male, 10 randomised to physiotherapist-led exercise). Many participants were unable to recall their experiences of trial processes; nonetheless, three themes were identified from the data: experience of shoulder pain and pathway to treatment; communication and decision-making in the context of rotator cuff repair surgery; and experiences of the POWER physiotherapist-led exercise intervention and processes.
Conclusions
Patients experience significant burden due to shoulder pain. Their journey to surgery can be long, confusing, and associated with perceived abandonment. In a future trial, the intervention should offer opportunity for shared decision-making, optional exit from the surgical pathway, and an individualised exercise programme.
| Original language | English |
|---|---|
| Article number | 102893 |
| Journal | Musculoskeletal Science and Practice |
| Volume | 69 |
| Early online date | 7 Dec 2023 |
| DOIs | |
| Publication status | Published - 1 Feb 2024 |
Bibliographical note
Publisher Copyright:© 2023 The Author(s)