Patients' views on responsibility for the management of musculoskeletal disorders--a qualitative study.
BACKGROUND
Musculoskeletal disorders are very common and almost inevitable in an individual's lifetime. Enabling self-management and allowing the individual to take responsibility for care is stated as desired in the management of these disorders, but this may be asking more than people can generally manage. A willingness among people to take responsibility for musculoskeletal disorders and not place responsibility out of their hands or on employers but to be shared with medical professionals has been shown. The aim of the present study was to describe how people with musculoskeletal disorders think and reason regarding responsibility for prevention, treatment and management of the disorder.


METHODS
Individual interviews with a strategic sample of 20 individuals with musculoskeletal disorders were performed. The interviews were tape-recorded, transcribed verbatim and analysed according to qualitative content analysis.


RESULTS
From the interviews an overarching theme was identified: own responsibility needs to be met. The analysis revealed six interrelated categories: Taking on responsibility, Ambiguity about responsibility, Collaborating responsibility, Complying with recommendations, Disclaiming responsibility, and Responsibility irrelevant. These categories described different thoughts and reasoning regarding the responsibility for managing musculoskeletal disorders. Generally the responsibility for prevention of musculoskeletal disorders was described to lie primarily on society/authorities as they have knowledge of what to prevent and how to prevent it. When musculoskeletal disorders have occurred, health care should provide fast accessibility, diagnosis, prognosis and support for recovery. For long-term management, the individuals themselves are responsible for making the most out of life despite disorders.


CONCLUSIONS
No matter what the expressions of responsibility for musculoskeletal disorders are, own responsibility needs to be met by society, health care, employers and family in an appropriate way, with as much or as little of the "right type" of support needed, based on the individual's expectations.
Larsson
Maria E H
ME
Department of Clinical Neuroscience and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden. maria.eh.larsson@vgregion.se
Nordholm
Lena A
LA
Ohrn
Ingbritt
I
D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology* / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D010865:Pilot Projects; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology*
BMC Musculoskelet Disord. 2008 Aug 05;9:110
18681967
Spine (Phila Pa 1976). 2002 Mar 1;27(5):E109-20
11880847
Psychol Monogr. 1966;80(1):1-28
5340840
J Consult Clin Psychol. 1989 Oct;57(5):652-7
2794186
Res Nurs Health. 2000 Aug;23(4):334-40
10940958
Disabil Rehabil. 2002 Dec 15;24(18):948-53
12523948
Knee Surg Sports Traumatol Arthrosc. 2008 Feb;16(2):118-27
18034333
Physiother Res Int. 2007 Sep;12(3):126-35
17624898
Nurse Educ Today. 2004 Feb;24(2):105-12
14769454
Pain. 1987 Oct;31(1):53-64
3696743
Pain. 1988 Feb;32(2):173-183
3362555
Arch Phys Med Rehabil. 2008 Sep;89(9):1830-45
18760171
Psychol Rev. 1977 Mar;84(2):191-215
847061
J Manipulative Physiol Ther. 2000 Jul-Aug;23(6):409-13
10951311
Bull World Health Organ. 2003;81(9):646-56
14710506
Health Educ Monogr. 1978 Spring;6(2):160-70
689890