RT Journal Article
SR Electronic
T1 A qualitative study of patients’ perceptions and priorities when living with primary frozen shoulder
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e003452
DO 10.1136/bmjopen-2013-003452
VO 3
IS 9
A1 Susan Jones
A1 Nigel Hanchard
A1 Sharon Hamilton
A1 Amar Rangan
YR 2013
UL http://bmjopen.bmj.com/content/3/9/e003452.abstract
AB Objectives To elucidate the experiences and perceptions of people living with primary frozen shoulder and their priorities for treatment. Design Qualitative study design using semistructured interviews. Setting General practitioner (GP) and musculoskeletal clinics in primary and secondary care in one National Health Service Trust in England. Participants 12 patients diagnosed with primary frozen shoulder were purposively recruited from a GP's surgery, community clinics and hospital clinics. Recruitment targeted the phases of frozen shoulder: pain predominant (n=5), stiffness predominant (n=4) and residual stiffness predominant following hospital treatment (n=2). One participant dropped out. Inclusion criteria: adult, male and female patients of any age, attending the clinics, who had been diagnosed with primary frozen shoulder. Results The most important experiential themes identified by participants were: pain which was severe as well as inexplicable; inconvenience/disability arising from increasing restriction of movement (due to pain initially, gradually giving way to stiffness); confusion/anxiety associated with delay in diagnosis and uncertainty about the implications for the future; and treatment-related aspects. Participants not directly referred to a specialist (whether physiotherapist, physician or surgeon) wanted a faster, better-defined care pathway. Specialist consultation brought more definitive diagnosis, relief from anxiety and usually self-rated improvement. The main treatment priority was improved function, though there was recognition that this might be facilitated by relief of pain or stiffness. There was a general lack of information from clinicians about the condition with over-reliance on verbal communication and very little written information. Conclusions Awareness of frozen shoulder should be increased among non-specialists and the best available information made accessible for patients. Our results also highlight the importance of patient participation in frozen shoulder research.