Self-management of a musculoskeletal condition for people from harder to reach groups: a qualitative patient interview study.
Jo Adams, Wendy Lowe, Joanne Protheroe and 5 others
PMID 30369265WHAT IT FOUND
Patients with musculoskeletal conditions reported that clinicians focused on medication and cure, leaving them feeling hopeless about self-management.
They relied on family, neighbours, and community networks for practical support and understanding, rather than finding clear guidance in rushed clinical consultations.
Key findings
01Participants felt self-management was not a priority because they heard from providers that only medication could help and the condition could not be cured.
02Family, friends, and neighbours were identified as more important sources of support for managing pain than fleeting contacts with health care professionals.
03There was no difference in the self-management strategies described by participants with low versus adequate functional health literacy scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was small (18 participants), limiting the breadth of experiences captured. Participants were recruited via community contacts who identified them as having lower health literacy, but 8 scored as having adequate functional health literacy, suggesting the recruitment criteria may not have perfectly matched the literacy levels. The study excluded people who did not speak English as a first language, limiting generalizability to diverse populations. The REALM-SF only measures functional health literacy, not interactive or critical skills, which may have been more relevant to the participants' struggles.
Declared interests
The study was funded by Arthritis Research UK. The authors declared no other conflicts of interest.
The easy way to misread this
Do not assume that patients with higher measured functional health literacy will easily engage with self-management. The study found no difference in reported strategies or barriers between participants with low and adequate literacy scores, suggesting that systemic communication issues affect all patients regardless of reading ability.