Factors Influencing Shoulder Joint Function in Patients With Type 2 Diabetes Mellitus Following Arthroscopic Rotator Cuff Repair: A Mixed-Methods Study.

Abstract

To identify the influencing factors of shoulder joint function after Arthroscopic Rotator Cuff Repair (ARCR) in patients with Type 2 Diabetes Mellitus (T2DM). A sequential explanatory mixed-methods design was conducted. Participants were recruited from the Northern Jiangsu People's Hospital from January 2023 to May 2023. Quantitative data were collected using the Constant-Murley Shoulder Joint Function Score, the General Self-Efficacy Scale, and the Perceived Social Support Scale. A total of 134 patients were recruited (120 participants for questionnaire survey, 14 participants for interview). Spearman's correlations were performed to initially identify the influencing factors of shoulder joint function. Qualitative data were collected through face-to-face interviews with 14 patients. To understand patients' experiences during the process of shoulder joint recovery, interpretative phenomenological analysis was employed. The triangulation was conducted using convergence coding matrix. Three themes and seven sub-themes were identified, including capability (postoperative pain management, self-management of T2DM), opportunity (medical supports, perceived social and family supports, demands of economic supports), and motivation (sense of benefits, psychological motivation). The recovery of shoulder joint function in patients with T2DM following ARCR is influenced by factors related to capability, opportunity, and motivation. Healthcare providers should enhance the timing and content of educational interventions and provide intensive psychological support to facilitate successful behavior change and optimize shoulder joint recovery in this patient population. The findings of this study can inform the development of an optimized care model for patients with T2DM following ARCR, empowering them to take control of their condition. Considering the long-term challenges of rehabilitation, which present physical and psychological difficulties for patients, it is essential to design interventions strategies that address physiological decline and pain management.