Abstract
BackgroundExtracorporeal shockwave therapy (ESWT) is used to manage different tendinopathies and appears to be effective in some tendinopathies but not others. The reasons for this are unclear. There is evidence that patient outcomes can be influenced by a patient-centred approach. There is therefore a need to qualitatively evaluate patient experiences for a treatment like ESWT where uncertainties exist. The aim of this study was to understand patients’ overall perspective of ESWT to manage their tendinopathy.MethodsA qualitative semi-structured face-to-face interview study design was used and the data was analysed thematically using ‘Framework Analysis’.ResultsEleven participants that have had radial ESWT (rESWT) to treat a range of tendinopathies were recruited from a private London sports clinic and interviewed in person or via Skype™. Four main themes and 16 subthemes were identified. Subthemes included previous failed treatment, clinician factors, mechanisms of ESWT, positive aspects, negative aspects, responsibility over own health and perceived outcomes.ConclusionThe participants understood the procedural aspects of rESWT, but were largely unaware of its mechanism of action and whether it was found to be effective for their condition or not. The participants felt that self-management measures were equally or more important than rESWT to help treat their tendinopathies. Recommendations would be for rESWT providers to offer patients written information, maintain continuity of care, address patients’ expectations, feedback on progress, and encourage self-management measures such as activity modification.
Highlights
Introduction of interviewer and overview of the study Discussion on consent, confidentiality and the interview procedure Check if interviewee has any questions and happy to proceed
How did interviewees first hear about radial ESWT (rESWT)? If applicable, cover any background reading done What did interviewees understand about how rESWT works? What did interviewees understand about the procedure itself? Cover any side-effects What did interviewees expect would be the outcome after rESWT? Short and long term outcomes Discuss what interviewees personally would consider a successful outcome
What were interviewees told about rESWT by the healthcare professional? If this has already been covered from previous questions omit If applicable, ask how interviewees feel this changed what they initially understood and expected from the procedure What were interviewees’ first experiences of rESWT like? Cover number of shocks, interactions with the professional performing the procedure, positive/negative effects and experiences Did interviewees feel their experience of rESWT was what they expected? If so, why? If not, why not? Cover anything that was done well and anything that could have been done better What are interviewees’ current views about rESWT? Relevant or not relevant to the interviewees’ tendinopathy condition Cover interviewees’ perceived outcome from the procedure
Summary
Introduction of interviewer and overview of the study Discussion on consent, confidentiality and the interview procedure Check if interviewee has any questions and happy to proceed. Extracorporeal shockwave therapy (ESWT) is used to manage different tendinopathies and appears to be effective in some tendinopathies but not others. Cover any side-effects What did interviewees expect would be the outcome after rESWT? If this has already been covered from previous questions omit If applicable, ask how interviewees feel this changed what they initially understood and expected from the procedure What were interviewees’ first experiences of rESWT like? Interactions with the professional performing the procedure, positive/negative effects and experiences Did interviewees feel their experience of rESWT was what they expected? Respondent validation was conducted via email with 5/11 voluntary participants to ensure their data was correctly interpreted and the findings were complete
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