The perceptions of individuals with musculoskeletal disorders towards prognosis: An exploratory qualitative study.

QUESTION(S) How do individuals living with musculoskeletal disorders perceive the concept of prognosis? DESIGN Exploratory phenomenological study. PARTICIPANTS Individuals aged 18 years or older currently experiencing a musculoskeletal disorder. DATA ANALYSIS Single semi-structured one-on-one interviews were conducted. Data was analysed using inductive coding and thematic analysis. RESULTS Five themes were identified. First, participants defined prognosis as the likely outcome associated with their diagnosis. Their prognosis was often associated with outcomes related to pain, tissue health, and function. Second, participants perceived pain as having a negative impact on their prognosis by limiting their function and having a psychological impact. Third, participants held biomedical views in that tissue health was perceived as a cause for their pain and that tissue healing was essential for pain cessation. It was also difficult for participants to distinguish between pain related to tissue damage, and pain that was not. Fourth, participants use their ability to complete leisure and functional activities to determine the success of their recovery. Finally, participants perceived receiving individual prognoses for pain, tissue health, and function that may be simultaneously occurring as both important and beneficial. CONCLUSION Overall, participants viewed receiving prognostic information as important and beneficial. When constructing their views on prognosis participants perceived that pain, tissue health, and functional ability could all impact upon prognosis, whilst having a prognosis of their own. Physiotherapists should consider conceptualising and discussing prognosis in terms of pain, tissue health, and function when managing musculoskeletal disorders.

[1]  Jodi L. Young,et al.  What do patients referred to physical therapy for a musculoskeletal condition expect? A qualitative assessment. , 2022, Musculoskeletal science & practice.

[2]  J. McAuley,et al.  Feeling reassured after a consultation does not reduce disability or healthcare use in people with acute low back pain: a mediation analysis of a randomised trial. , 2021, Journal of physiotherapy.

[3]  S. Bunzli,et al.  Beliefs about the body and pain: the critical role in musculoskeletal pain management. , 2020, Brazilian journal of physical therapy.

[4]  L. Wiles,et al.  Implementing high value back pain care in private physiotherapy in Australia: A qualitative evaluation of physiotherapists who participated in an “implementation to innovation” system , 2020, Canadian journal of pain = Revue canadienne de la douleur.

[5]  N. Foster,et al.  Therapeutic alliance facilitates adherence to physiotherapy-led exercise and physical activity for older adults with knee pain: a longitudinal qualitative study. , 2019, Journal of physiotherapy.

[6]  N. King,et al.  A descriptive phenomenological analysis of the experience of blood donation as a regular donor , 2019, Journal of health psychology.

[7]  C. Thigpen,et al.  Value-Based Care for Musculoskeletal Pain: Are Physical Therapists Ready to Deliver? , 2019, Physical therapy.

[8]  T. Hoffmann,et al.  Shared decision making should be an integral part of physiotherapy practice. , 2019, Physiotherapy.

[9]  F. Cicuttini,et al.  People with low back pain want clear, consistent and personalised information on prognosis, treatment options and self-management strategies: a systematic review. , 2019, Journal of physiotherapy.

[10]  S. Loftus,et al.  Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. , 2018, The Journal of orthopaedic and sports physical therapy.

[11]  B. Saragiotto,et al.  Primary care management of non‐specific low back pain: key messages from recent clinical guidelines , 2018, The Medical journal of Australia.

[12]  F. Cicuttini,et al.  Patients' perceived needs of health care providers for low back pain management: a systematic scoping review. , 2018, The spine journal : official journal of the North American Spine Society.

[13]  Kelsey J Picha,et al.  A model to increase rehabilitation adherence to home exercise programmes in patients with varying levels of self‐efficacy , 2018, Musculoskeletal care.

[14]  K. Refshauge,et al.  Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes? , 2018, Physiotherapy theory and practice.

[15]  A. Moser,et al.  Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis , 2017, The European journal of general practice.

[16]  M. Hancock,et al.  Adults attending private physiotherapy practices seek diagnosis, pain relief, improved function, education and prevention: a survey. , 2017, Journal of physiotherapy.

[17]  E. Puentedura,et al.  The clinical implementation of pain neuroscience education: A survey study , 2017, Physiotherapy theory and practice.

[18]  I. Diener,et al.  The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature , 2016, Physiotherapy theory and practice.

[19]  P. Coales,et al.  Clinical challenges of classification based targeted therapies for non-specific low back pain: What do physiotherapy practitioners and managers think? , 2015, Manual therapy.

[20]  A. Taylor,et al.  Initial assessment and management of pain: a pathway for care developed by the British Pain Society. , 2014, British journal of anaesthesia.

[21]  Richard D Riley,et al.  Prognosis research strategy (PROGRESS) 1: A framework for researching clinical outcomes , 2013, BMJ : British Medical Journal.

[22]  N. Foster,et al.  Taking responsibility for the early assessment and treatment of patients with musculoskeletal pain: a review and critical analysis , 2012, Arthritis Research & Therapy.

[23]  P. Tugwell,et al.  Health Literacy: What Is It and Why Is It Important to Measure? , 2011, The Journal of Rheumatology.

[24]  C. Bagley,et al.  Patients' misunderstanding of common orthopaedic terminology: the need for clarity. , 2011, Annals of the Royal College of Surgeons of England.

[25]  S. George,et al.  Fear-avoidance beliefs and clinical outcomes for patients seeking outpatient physical therapy for musculoskeletal pain conditions. , 2011, The Journal of orthopaedic and sports physical therapy.

[26]  J. Cleland,et al.  Individual Expectation: An Overlooked, but Pertinent, Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain , 2010, Physical Therapy.

[27]  Yvonne Vergouwe,et al.  Prognosis and prognostic research: what, why, and how? , 2009, BMJ : British Medical Journal.

[28]  N. O’Connell,et al.  Towards a mechanisms-based classification of pain in musculoskeletal physiotherapy? , 2008 .

[29]  F. Apiribu,et al.  Exploring the reasons for novice nurse educators’ transition from practice to academia in Ghana , 2007, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[30]  A. Luque-Suarez,et al.  The Role of Self-Efficacy on the Prognosis of Chronic Musculoskeletal Pain: A Systematic Review. , 2018, The journal of pain : official journal of the American Pain Society.

[31]  Anne Galletta,et al.  Mastering the Semi-Structured Interview and Beyond , 2017 .

[32]  V. Braun,et al.  Please Scroll down for Article Qualitative Research in Psychology Using Thematic Analysis in Psychology , 2022 .