Exploring the experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative study within the POWER pilot and feasibility trial

MOFFATT, MARIA; Wade, Julia; Foster, Nadine; Littlewood, Chris

Abstract

Background: As waiting times for orthopaedic surgery increase, there have been calls to move from {\textquoteleft}waiting lists{\textquoteright} to {\textquoteleft}preparation lists{\textquoteright}, 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 experiences of adults awaiting rotator cuff repair surgery in the NHS●Explore the acceptability of the physiotherapist-led exercise intervention●Explore barriers and enablers to recruitment, retention, and adherence Design: Integrated qualitative study with semi-structured telephone interviewsMethods: 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 to 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.

Citation

MOFFATT, M., Wade, J., Foster, N., & Littlewood, C. (2024). Exploring the experiences and perceptions of patients awaiting rotator cuff repair surgery: an integrated qualitative study within the POWER pilot and feasibility trial. Musculoskeletal Science and Practice, 69, 1--28. https://doi.org/10.1016/j.msksp.2023.102893

• Journal Article Type: Article
• Acceptance Date: Nov 30, 2023
• Online Publication Date: Dec 7, 2023
• Publication Date: Feb 29, 2024
• Deposit Date: Nov 11, 2024
• Publicly Available Date: Nov 12, 2024
• Journal: Musculoskeletal Science and Practice
• Print ISSN: 2468-7812
• Electronic ISSN: 2468-7812
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 69
• Pages: 1--28
• DOI: https://doi.org/10.1016/j.msksp.2023.102893
• Keywords: Rotator cuff, surgery, patient experience, qualitative, Surgery, Patient experience, Qualitative
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2468781223001789