■肩峰下疼痛综合征(SAPS)是一种常见的持续性疼痛病症。运动护理是一线推荐,但是运动剂量不足会妨碍效果。这项研究探讨了SAPS患者提供和遵守基于运动的护理的个人和背景障碍以及促进者。
■这项探索性定性研究的参与者参与了丹麦SAPS的管理。在3个主题(提供推荐服务,坚持建议,和临床路径的框架)使用理论域框架(TDF)和行为变化轮模型(BCW)将障碍和促进者映射到能力中,机会,动机和行为(COM-B)模型。
■通过对10名SAPS人员和37名医疗保健从业人员的访谈以及双重演绎分析,在13个TDF域中出现了30个目标行为的受试者,它们跨越了视角和COM-B组件。分娩和依从性的主要障碍是诊断术语的不一致,跨专业的分歧,信仰,以及对Pathway服务的期望。
■我们在BCW的所有方面确定了相互关联的个人和背景障碍,支撑主题的复杂性。研究结果支持,基于运动的护理的有效性与交付和依从性的背景障碍有关。
基于运动的护理是推荐的肩峰下疼痛综合征(SAPS)的一线护理,但是运动剂量不足会妨碍效果。术语和护理不一致,分歧的信仰和跨专业的分歧,对路径服务的不同期望是提供和遵守推荐的基于运动的护理的主要挑战。轻松访问关键信息,检查和治疗建议,以人为本的方法,HCP之间的患者信息对齐有助于遵守临床建议。
UNASSIGNED: Subacromial Pain Syndrome (SAPS) is a common persistent pain condition. Exercise-based care is first-line recommendation, but an insufficient exercise dose hampers effectiveness. This
study explores individual and contextual barriers and facilitators for delivery of and adherence to exercise-based care in people with SAPS.
UNASSIGNED: Participants in this exploratory qualitative
study were involved in the management of SAPS in Denmark. Triangular interviews and analyses were conducted within 3 themes (delivery of recommended services, adherence to recommendations, and frames of the clinical pathways) using the Theoretical Domains Framework (TDF) and the Behavioural Change Wheel model (BCW) to map barriers and facilitators into the Capability, Opportunity, Motivation and Behaviour (COM-B) model.
UNASSIGNED: From interviews with 10 persons with SAPS and 37 healthcare practitioners and double-deductive analyses, 30 subjects of target behaviour within 13 TDF domains emerged across perspectives and COM-B components. Central barriers to delivery and adherence were inconsistencies in diagnostic terminology, cross-professional disagreements, beliefs, and expectations towards pathway services.
UNASSIGNED: We identified interrelated individual and contextual barriers to delivery and adherence across all aspects of the BCW, underpinning the complexity of the subject. Findings support that effectiveness of exercise-based care is linked to contextual barriers to delivery and adherence.
Exercise-based care is the recommended first-line care for Subacromial Pain Syndrome (SAPS), but an insufficient exercise dose hampers effectiveness.Inconsistencies in terminology and care, diverging beliefs and cross-professional disagreements, and varying expectations of pathway services are the main challenges to delivery of and adherence to recommended exercise-based care.Easy access to key information, examination and treatment suggestions, a person-centred approach, and alignment in patient information between HCPs facilitate adherence to clinical recommendations.