“Please listen to me, I want to know what is wrong with my shoulder”: A qualitative study exploring patients’ expectations and experiences with primary care management.

Abstract

Background: The management of shoulder pain is challenging for primary care clinicians considering that 40% of affected individuals remain symptomatic one year after initial consultation. Developing tailored knowledge translation interventions founded on evidence-based recommendations while also considering patients’ expectations could improve primary care for shoulder pain. The aim of this qualitative study is to explore patients’ expectations and experiences of their primary care consultation for shoulder pain. Methods: In this qualitative study, participants with shoulder pain and having consulted a primary care physician in the past year were interviewed. All the semi-structured interviews were transcribed into verbatims, and inductive thematic analysis was performed to identify themes related to the participants’ expectations and experiences of primary care consultations for shoulder pain. Results: Thirteen participants with shoulder pain were interviewed (8 women, 5 men; mean age 50 ± 12 years). Eleven of them initially consulted a family or an emergency physician, and two participants initially consulted a physiotherapist. Four overarching themes related to patients’ expectations and experiences were identified from our thematic analysis: 1) I can’t sleep because of my shoulder; 2) I need to know what is happening with my shoulder; 3) But… we need to really see what is going on to help me!; and 4) Please take some time with me so I can understand what to do!. Several participants waited until they experienced a high level of shoulder pain before making an appointment since they were not confident about what their family physician could do to manage their condition. Although some participants felt that their physician took the time to listened to their concerns, many were dissatisfied with the limited assessment and education provided by the clinician. Conclusions: Implementing evidence-based recommendations while also considering patients’ expectations is important as it may improve care delivery and patients’ satisfaction with care. Several participants reported that their expectations were not met, especially when it came to the explanations provided. One unexpected finding that emerged from this study was the delay between the onset of shoulder pain and when patients decided to consult their primary care clinician.

Low back pain patients' experience and expectations: A qualitative study focusing on physiotherapist and physician care

“…In one study conducted by our team on shoulder pain, a longer delay for consulting was also reported (Lowry et al., 2023). The delay observed here could also be influenced by the fact that some participants did not believe that their FP could help them, as previously reported (Kannan & Veazie, 2014; Liddle et al., 2007; Lowry et al., 2023). To ensure a favourable management, the actual role of FP and the available therapeutic options they can offer should be better known.…”

“…In another qualitative study on knee pain, participants reported delaying consultation because they believed it was normal to experience pain due to ageing and were unaware of the importance of prevention or early management to prevent significant disability (Prasanna et al, 2013). In one study conducted by our team on shoulder pain, a longer delay for consulting was also reported (Lowry et al, 2023). The delay observed here could also be influenced by the fact that some participants did not believe that their FP could help them, as previously reported (Kannan & Veazie, 2014;Liddle et al, 2007;Lowry et al, 2023).…”

“…The recruited participants presented various clinical presentations of LBP and had different episodes of care. The interview guide was developed based on another high‐quality qualitative study and adapted by our research team first for a shoulder pain qualitative study and then adapted for our current study LBP (Lowry et al., 2023; Maxwell et al., 2022). A few limitations are present with our study.…”

“…We conducted semi‐structured individual interviews pertaining to expectations and experiences of their journey (LBP management). The interview guide was developed by members of our research team (VL, YTL, KP, FD) inspired by a guide developed for our previous research on the experience and expectations of patients living with shoulder pain (Lowry et al., 2023). Five dimensions were addressed in the semi‐structured interview guide: personal experience of the patients and impact of LBP, their motivation to consult a primary care clinician, the expectations of the primary care consultation, their experience of shared decision‐making with the provider and their overall healthcare experience.…”

“…This project will allow the development of a knowledge translation intervention for professionals to specifically optimise the management of LBP and shoulder pain. This larger study included the consultation of primary care clinicians in which we explored barriers and facilitators to implementing LBP and shoulder pain management recommendations from CWC and the consultation of patients with shoulder pain (Lowry et al., 2023; Véronique et al., 2023).…”