Barriers and facilitators related to self-management of shoulder pain: a systematic review and qualitative synthesis

O'Shea, Aidan; Drennan, Jonathan; Littlewood, Chris; Slater, Helen; Sim, Julius; G. McVeigh, Joseph

Abstract

Objective: The objective of this review was to identify barriers and facilitators related to self-management from the perspectives of people with shoulder pain and clinicians involved in their care.

Data sources: CINAHL, MEDLINE, PsycINFO, SPORTDiscus, Embase, ProQuest Health, Web of Science, and Scopus were searched from inception to March 2022.

Review methods: A meta-aggregative approach to the synthesis of qualitative evidence was used. Two independent reviewers identified eligible articles, extracted the data, and conducted a critical appraisal. Two reviewers independently identified and developed categories, with validation by two further researchers. Categories were discussed among the wider research team and a comprehensive set of synthesized findings was derived.

Results: Twenty studies were included. From the perspective of patients, three synthesized findings were identified that influenced self-management: (1) support for self-management, including subthemes related to patient-centred support, knowledge, time, access to equipment, and patient digital literacy; (2) personal factors, including patient beliefs, patient expectations, patient motivation, pain, and therapeutic response; and (3) external factors, including influence of the clinician and therapeutic approach. From the perspective of clinicians, two synthesized findings were identified that influenced self-management: (1) support for self-management, including education, patient-centred support, patient empowerment, time, and clinician digital literacy; and (2) preferred management approach, including clinician beliefs, expectations, motivation, therapeutic approach, and therapeutic response.

Conclusion: The key barriers and facilitators were patient-centred support, patient beliefs, clinician beliefs, pain, and therapeutic response. Most of the included studies focused on exercise-based rehabilitation, and therefore might not fully represent barriers and facilitators to broader self-management.

Citation

O'Shea, A., Drennan, J., Littlewood, C., Slater, H., Sim, J., & G. McVeigh, J. (2022). Barriers and facilitators related to self-management of shoulder pain: a systematic review and qualitative synthesis. Clinical Rehabilitation, 36(11), 1539-1562. https://doi.org/10.1177/02692155221108553

• Journal Article Type: Article
• Acceptance Date: Jun 1, 2022
• Online Publication Date: Jun 22, 2022
• Publication Date: Jun 22, 2022
• Deposit Date: Nov 18, 2024
• Publicly Available Date: Nov 22, 2024
• Journal: Clinical Rehabilitation
• Print ISSN: 0269-2155
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 36
• Issue: 11
• Pages: 1539-1562
• DOI: https://doi.org/10.1177/02692155221108553
• Keywords: Shoulder pain, self-management, qualitative synthesis, systematic review, Exploratory studies