P Malliaras, T P Haines, F Burstein, D Connell, P Delir Haghighi, T Hoffmann, J Neil, P Nicklen, H Skouteris, R S Page, R Whale, I Harris, J R Zadro
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引用次数: 0
Abstract
Background: Unnecessary imaging for rotator cuff related shoulder pain is common and may be related to inadequate shared decision making.
Objective: To develop and evaluate a patient decision aid (PDA) for people with rotator cuff-related shoulder pain to inform decision-making.
Design: Mixed-methods study guided by the International Patient Decision Aids Standards.
Methods: A multidisciplinary steering group guided this research. The PDA was developed iteratively, incorporating feedback from people with shoulder pain and health professionals through semi-structured interviews and acceptability questionnaires (1 = strongly disagree and 5 = strongly agree). Thematic analysis of qualitative data and descriptive analysis of quantitative data was undertaken.
Results: Twenty health professionals and nineteen patients participated in interviews, while a separate cohort of 54 patients and 15 health professionals completed acceptability questionnaires. Most patients (74-98 %) rated the PDA as acceptable, though 37 % perceived it as biased against imaging. Health professionals (median agreement score 4/5) found the PDA useful but highlighted concerns about feasibility in time-constrained settings. Interview feedback emphasized clarity, contextualization of imaging findings, and alignment with clinical guidelines. When using the final version of the PDA in a clinical encounter, all five patients (100 %) reported that the information in the decision aid influenced their decision to have a scan, and four of the five health professionals (80 %) reported that they would use the decision aid in their practice.
Conclusion: This decision aid appears to be an acceptable and useful tool for helping people with rotator cuff-related shoulder pain to make informed decisions about imaging. A randomized controlled trial evaluating whether this decision aid reduces people's intentions to have imaging and facilitate informed treatment choices is now needed.
期刊介绍：
Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.
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