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Musculoskeletal Care

Panos Sarigiovannis, Steve Cropper
BACKGROUND: Physiotherapy assistants account for approximately 20% of the physiotherapy workforce across a community health service in North Staffordshire. Although their job descriptions state that the post is primarily clinical, their role depends heavily on the qualified physiotherapists and how they utilize their clinical skills. METHODS: An audit of the physiotherapy assistants' tasks was carried out to reveal whether the physiotherapy assistants' time spent on clinical tasks complied with their job descriptions...
March 13, 2018: Musculoskeletal Care
Sidona-Valentina Bala, Kristina Forslind, Bengt Fridlund, Peter Hagell
BACKGROUND: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum). OBJECTIVE: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics...
February 27, 2018: Musculoskeletal Care
M Bateman, E Whitby, S Kacha, E Salt
BACKGROUND: Tennis elbow is a common painful condition that may affect daily function and ability to work. Physiotherapy is the most commonly used primary intervention but there is a wide range of treatment options within the umbrella of physiotherapy. Our aim was to report on the treatments that are currently used by physiotherapists in a UK National Health Service (NHS) setting. METHODS: A retrospective service evaluation was conducted at two NHS hospital trusts by reviewing patient attendance records over a 1-year period...
February 22, 2018: Musculoskeletal Care
David Rogers, Peter Nightingale, Adrian Gardner
This service evaluation analysed the long-term clinical outcomes, as measured by the Pain Self-Efficacy Questionnaire (PSEQ) and Oswestry Disability Index (ODI), of a 12-h group-based, multidisciplinary, combined physical and psychological treatment programme for patients with persistent back pain in a secondary care setting. Between April 2012 and December 2015, 373 patients attended the programme, with outcome measures obtained for 272 patients post-treatment. We randomly selected 120 patients who had completed treatment, for long-term outcome measurement follow-up, and gained outcome measures for 40 patients in total...
February 15, 2018: Musculoskeletal Care
Sidona-Valentina Bala, Kristina Forslind, Bengt Fridlund, Karin Samuelson, Björn Svensson, Peter Hagell
BACKGROUND: Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics. METHODS: A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks...
February 8, 2018: Musculoskeletal Care
A Bremander, E Haglund, S Bergman, M Ndosi
OBJECTIVES: The aim of the present study was to validate the Swedish version of the educational needs assessment tool (SwENAT) in undifferentiated spondyloarthritis (USpA) and use it to study the educational needs of patients with USpA. METHODS: This was a cross-sectional study, recruiting a random sample of patients with USpA from a hospital register in Sweden. Educational needs data were collected, together with disease activity and function indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Bath Ankylosing Spondylitis Functional Index [BASFI])...
February 7, 2018: Musculoskeletal Care
Hayley McBain, Stanton Newman, Michael Shipley, Abigail Olaleye, Samantha Moore
OBJECTIVES: The aim of the present study was to explore patients' experience of a patient-initiated self-monitoring service for people with rheumatoid or psoriatic arthritis who are on methotrexate. METHODS: The study took the form of qualitative semi-structured interviews, embedded within a randomized controlled trial. Twelve participants who were randomly assigned to the intervention arm were interviewed. Interviews digitally, transcribed verbatim and analysed using inductive thematic analysis...
January 30, 2018: Musculoskeletal Care
Stephanie Holt, Jackie Waterfield
OBJECTIVES: Culture and ethnicity are acknowledged as important factors in the context of the biopsychosocial model. They may contribute to explaining the experience of pain, therapeutic encounters within healthcare, and the strategies that individuals use to cope with pain. The present study explored these issues in a sample of Indian Asian women in the UK. METHODS: Based on a phenomenological approach, 17 women participated in five semi-structured group interviews...
January 12, 2018: Musculoskeletal Care
Riikka Holopainen, Arja Piirainen, Ari Heinonen, Jaro Karppinen, Peter O'Sullivan
Low back pain is a considerable health problem which affects people around the world, causing major healthcare costs. The use of qualitative research methods enables us to describe and understand patients' experience of, and attitudes to, healthcare. The aim of the present phenomenographic study was to identify and describe the contextual nature of the conceptions of patients with low back pain of their encounters in the HCS. Seventeen patients with chronic or episodic low back pain classified as "high risk" were interviewed in open recall interviews, using videos of patients' initial physiotherapy sessions that had been recorded previously...
January 12, 2018: Musculoskeletal Care
Gunnel Östlund, Mathilda Björk, Ingrid Thyberg, Eva Valtersson, Annette Sverker
INTRODUCTION: The present study explored how women describe their use of situation-specific strategies when managing rheumatoid arthritis (RA). The aim was also to compare women's strategies with those of men, and see the extent to which they used the same strategies. METHODS: The data were collected using semi-structured interviews based on the critical incident technique. The sample consisted of women with early rheumatic arthritis (n = 34), and the results were compared with data reported in a previous study on men (n = 25) from the same cohort...
January 9, 2018: Musculoskeletal Care
M Chaleshgar-Kordasiabi, B Enjezab, M Akhlaghi, I Sabzmakan
OBJECTIVE: The aim of the present study was to explore the view of rheumatoid arthritis (RA) patients about the barriers and reinforcing factors in practising self-management behaviour (SMB). METHODS: This was a qualitative study based on directed content analysis of in-depth semi-structured interviews with 30 patients. The participants were selected using a purposeful sampling approach. The interviews continued until data saturation was reached. The study was conducted over 6 months in 2014-2015 at the Rheumatology Clinic of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran...
January 5, 2018: Musculoskeletal Care
Gro Opseth, Astrid Klopstad Wahl, Gustav Bjørke, Anne Marit Mengshoel
BACKGROUND: There is growing concern that an ageing population and increasing number of patients with chronic illnesses in the future will foster a need for health services beyond the resources available in society. Patients with chronic illnesses are reported to be frequent users of physicians' services in the primary health sector. Therapies for patients with chronic musculoskeletal illnesses are delivered by physiotherapists in this sector. However, we know little about the use of physiotherapy services and the factors that may explain their use...
December 20, 2017: Musculoskeletal Care
E L Healey, C Jinks, N E Foster, C A Chew-Graham, T Pincus, L Hartshorne, K Cooke, E Nicholls, J Proctor, M Lewis, S Dent, S Wathall, E M Hay, J McBeth
INTRODUCTION: This pilot trial will inform the design and methods of a future full-scale randomized controlled trial (RCT) and examine the feasibility, acceptability and fidelity of the Increasing Physical activity in Older People with chronic Pain (iPOPP) intervention, a healthcare assistant (HCA)-supported intervention to promote walking in older adults with chronic musculoskeletal pain in a primary care setting. METHODS AND ANALYSIS: The iPOPP study is an individually randomized, multicentre, three-parallel-arm pilot RCT...
March 2018: Musculoskeletal Care
Megan E Gath, Lisa K Stamp, Pip Aimer, Simon Stebbings, Gareth J Treharne
OBJECTIVES: Smokers with rheumatoid arthritis (RA) may have different motivations for, and barriers to, quitting. Understanding the motivations of smokers and ex-smokers with RA will help in the design and implementation of targeted smoking cessation interventions for people with RA that are not based solely on extrapolation from the general population or populations with other chronic illnesses. METHODS: Twenty-nine smokers and 10 recent ex-smokers with RA participated in semi-structured interviews via telephone 18 months after being offered a smoking cessation intervention in Aotearoa/New Zealand...
December 13, 2017: Musculoskeletal Care
Daniel G Fernández-Ávila, Álvaro J Ruiz, Fabián Gil, Sergio A Mora, Carlos Tobar, Juan M Gutiérrez, Diego Rosselli
OBJECTIVE: The aim of the present study was to evaluate the effectiveness of an educational tool for general physicians, based on rheumatological clinical simulation, for the diagnosis of rheumatoid arthritis and osteoarthritis. METHODS: A randomized clinical study was carried out, in which the physician research subjects were assigned to one of two groups: the experimental group (educational intervention for rheumatoid arthritis with clinical simulation) or the control group (educational intervention for the basic aspects of the diagnosis and treatment of osteoporosis)...
December 13, 2017: Musculoskeletal Care
E C P M Tak, J B van Meurs, S M A Bierma-Zeinstra, A Hofman, M Hopman-Rock
OBJECTIVE: The aim of the present study was to report on factors associated with changes in disability after 5 years, with a focus on physical activity (PA) in community-dwelling older adults with generalized radiographic osteoarthritis (GROA). METHODS: Assessment of GROA (hand, knee, hip) and disability (Health Assessment Questionnaire) in the Rotterdam Study (cohort RS-1, N = 7,983; with GROA, n = 821). A good outcome at follow-up was defined as improved or mild disability, and a poor outcome as worsened or severe disability...
December 2017: Musculoskeletal Care
Lindsay K Smith, Erik Lenguerrand, Ashley Blom, Jane Powell, Shea Palmer
Total hip arthroplasty (THA) is highly successful for reducing pain and improving function, providing health-related quality of life benefit. Demand for THA is increasing with associated increase in revision hip surgery. Hip arthroplasty surveillance (long-term follow up) can identify asymptomatically failing THA to prepare for revision surgery, reducing potential for complications or complexity of surgery. However, it is unknown whether the surveillance of THA can be shown to improve the patient outcomes or reduce costs around revision surgery...
December 2017: Musculoskeletal Care
Natália Cristina de Oliveira, Leslie Andrews Portes, Henrik Pettersson, Helene Alexanderson, Carina Boström
INTRODUCTION: Patients with systemic sclerosis (SSc) experience reduced exercise capacity and muscle strength compared with healthy subjects. There are also indications of reduced levels of physical activity. OBJECTIVE: To present the current knowledge of physical exercise in SSc. RESULTS: Most studies presently available [three case studies, one single subject experimental design, one study comparing patients with healthy controls, one quasi experimental design (pre-post), two clinical trials and two random controlled trials] have included small samples of patients, mostly composed of patients with and without pulmonary involvement...
December 2017: Musculoskeletal Care
John Booth, G Lorimer Moseley, Marcus Schiltenwolf, Aidan Cashin, Michael Davies, Markus Hübscher
Chronic musculoskeletal pain (CMP) refers to ongoing pain felt in the bones, joints and tissues of the body that persists longer than 3 months. For these conditions, it is widely accepted that secondary pathologies or the consequences of persistent pain, including fear of movement, pain catastrophizing, anxiety and nervous system sensitization appear to be the main contributors to pain and disability. While exercise is a primary treatment modality for CMP, the intent is often to improve physical function with less attention to secondary pathologies...
December 2017: Musculoskeletal Care
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
December 2017: Musculoskeletal Care
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