The complexity of patient adherence in orthopaedics: A qualitative study to identify barriers and develop strategies for adherence partnerships.

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2023-12-01 Epub Date: 2023-09-11 DOI:10.1002/msc.1817
Kylee Rucinski, James L Cook, Lisa A Royse
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Abstract

Introduction: While the importance of patient adherence to treatment protocols is firmly accepted, a definition for adherence and mechanisms to address non-adherence are not well established. The goals of this study were to define adherence and identify barriers and enablers for adherence partnerships through the lens of the orthopaedic healthcare team.

Methods: The qualitative study was designed using concepts from grounded theory. Eight focus groups, comprised of orthopaedic healthcare team members, were conducted to identify factors influencing orthopaedic patient adherence to treatment plans.

Results: Healthcare team members identified a range of factors affecting patient adherence. Participants conveyed that patient non-adherence can be a deliberate decision but can also result from barriers faced by the patient. Synthesis of themes identified distinct phases of adherence and culminated in the creation of a preliminary model that encapsulates healthcare team and patient factors impacting adherence, which was entitled, The Barriers and Enablers to Treatment Adherence (BETA) Model.

Conclusion: The study findings alleviate the patient from the sole burden of adherence, recognising the influences that the healthcare team and system have on patients' ability to adhere. The BETA model of patient adherence represents the first step to mitigating non-adherence by providing a foundation for programmatic research aimed at developing and evaluating interventions and management strategies that empower healthcare teams to effectively equip patients for adherence, leading to optimised patient outcomes following orthopaedic interventions.

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矫形外科患者坚持治疗的复杂性:一项定性研究,旨在识别障碍并制定坚持治疗伙伴关系的策略。
导言:虽然患者坚持治疗方案的重要性已被广泛接受,但坚持治疗的定义和解决不坚持治疗问题的机制却没有得到很好的确立。本研究的目标是通过骨科医疗团队的视角来定义依从性,并确定依从性伙伴关系的障碍和促进因素:定性研究的设计采用了基础理论的概念。由骨科医疗团队成员组成的八个焦点小组进行了讨论,以确定影响骨科患者坚持治疗计划的因素:结果:医疗团队成员发现了一系列影响患者坚持治疗的因素。参与者表示,患者不坚持治疗可能是故意做出的决定,但也可能是患者面临的障碍造成的。对主题的综合确定了坚持治疗的不同阶段,并最终创建了一个初步模型,概括了医疗团队和患者影响坚持治疗的因素,该模型被命名为 "坚持治疗的障碍和促进因素(BETA)模型":研究结果减轻了患者在坚持治疗方面的唯一负担,认识到了医疗团队和医疗系统对患者坚持治疗能力的影响。患者坚持治疗的 BETA 模型是减轻患者不坚持治疗的第一步,它为旨在开发和评估干预措施和管理策略的计划性研究奠定了基础,这些措施和策略可增强医疗团队的能力,使患者能够有效地坚持治疗,从而优化患者在接受骨科干预后的治疗效果。
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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
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