Linda J Carroll1, Angela Lis2, Sherri Weiser3, Jacqueline Torti4. 1. L.J. Carroll, PhD, School of Public Health, University of Alberta, 4075 RTF, 8308 114 St, Edmonton, Alberta T6G 2E1, Canada. lcarroll@ualberta.ca. 2. A. Lis, PT, PhD, Occupational and Industrial Orthopedic Center, New York University School of Medicine, New York, New York. 3. S. Weiser, PhD, Occupational and Industrial Orthopedic Center, New York University School of Medicine and Graduate School of Arts and Sciences. 4. J. Torti, MA, School of Public Health, University of Alberta.
Abstract
BACKGROUND: Expecting to recover from a musculoskeletal injury is associated with actual recovery. Expectations are potentially modifiable, although it is not well understood how injured people formulate expectations. A better understanding of how expectations are formulated may lead to better knowledge about how interventions might be implemented, what to intervene on, and when to intervene. OBJECTIVES: The objective of this study was to explore what "recovery" meant to participants, whether they expected to "recover," and how they formed these expectations. METHODS: This qualitative study used interpretive phenomenological analysis. Eighteen semistructured interviews were conducted with people seeking treatment for recent musculoskeletal injuries. RESULTS: Recovery was conceptualized as either (1) complete cessation of symptoms or pain-free return to function or (2) return to function despite residual symptoms. Expectations were driven by desire for a clear diagnosis, belief (or disbelief) in the clinician's prognosis, prior experiences, other people's experiences and attitudes, information from other sources such as the Internet, and a sense of self as resilient. CONCLUSIONS: Expectations appear to be embedded in both hopes and fears, suggesting that clinicians should address both when negotiating realistic goals and educating patients. This approach is particularly relevant for cases of nonspecific musculoskeletal pain, where diagnoses are unclear and treatment may not completely alleviate pain.
BACKGROUND: Expecting to recover from a musculoskeletal injury is associated with actual recovery. Expectations are potentially modifiable, although it is not well understood how injured people formulate expectations. A better understanding of how expectations are formulated may lead to better knowledge about how interventions might be implemented, what to intervene on, and when to intervene. OBJECTIVES: The objective of this study was to explore what "recovery" meant to participants, whether they expected to "recover," and how they formed these expectations. METHODS: This qualitative study used interpretive phenomenological analysis. Eighteen semistructured interviews were conducted with people seeking treatment for recent musculoskeletal injuries. RESULTS: Recovery was conceptualized as either (1) complete cessation of symptoms or pain-free return to function or (2) return to function despite residual symptoms. Expectations were driven by desire for a clear diagnosis, belief (or disbelief) in the clinician's prognosis, prior experiences, other people's experiences and attitudes, information from other sources such as the Internet, and a sense of self as resilient. CONCLUSIONS: Expectations appear to be embedded in both hopes and fears, suggesting that clinicians should address both when negotiating realistic goals and educating patients. This approach is particularly relevant for cases of nonspecific musculoskeletal pain, where diagnoses are unclear and treatment may not completely alleviate pain.
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