How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment

Joshua R. Zadro; Zoe A. Michaleff; Mary O'Keeffe; Giovanni E. Ferreira; Adrian C. Traeger; Andrew R. Gamble; Frederick Afeaki; Yaozhuo Li; Erya Wen; Jiawen Yao; Kejie Zhu; Richard Page; Ian A. Harris; Christopher G. Maher

doi:10.1136/bmjopen-2022-069779

How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment

Joshua R. Zadro^*, Zoe A. Michaleff, Mary O'Keeffe, Giovanni E. Ferreira, Adrian C. Traeger, Andrew R. Gamble, Frederick Afeaki, Yaozhuo Li, Erya Wen, Jiawen Yao, Kejie Zhu, Richard Page, Ian A. Harris, Christopher G. Maher

^*Corresponding author for this work

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

Objectives:

To explore how people perceive different advice for rotator cuff disease in terms of words/feelings evoked by the advice and treatment needs.

Setting:

We performed a content analysis of qualitative data collected in a randomised experiment.

Participants

2028 people with shoulder pain read a vignette describing someone with rotator cuff disease and were randomised to: bursitis label plus guideline-based advice, bursitis label plus treatment recommendation, rotator cuff tear label plus guideline-based advice and rotator cuff tear label plus treatment recommendation. Guideline-based advice included encouragement to stay active and positive prognostic information. Treatment recommendation emphasised that treatment is needed for recovery.

Primary and secondary outcomes:

Participants answered questions about: (1) words/feelings evoked by the advice; (2) treatments they feel are needed. Two researchers developed coding frameworks to analyse responses.

Results:

1981 (97% of 2039 randomised) responses for each question were analysed. Guideline-based advice (vs treatment recommendation) more often elicited words/feelings of reassurance, having a minor issue, trust in expertise and feeling dismissed, and treatment needs of rest, activity modification, medication, wait and see, exercise and normal movements. Treatment recommendation (vs guideline-based advice) more often elicited words/feelings of needing treatment/investigation, psychological distress and having a serious issue, and treatment needs of injections, surgery, investigations, and to see a doctor.

Conclusions:

Words/feelings evoked by advice for rotator cuff disease and perceived treatment needs may explain why guideline-based advice reduces perceived need for unnecessary care compared to a treatment recommendation.

Original language	English
Article number	e069779
Pages (from-to)	1-10
Number of pages	10
Journal	BMJ Open
Volume	13
Issue number	5
DOIs	https://doi.org/10.1136/bmjopen-2022-069779
Publication status	Published - 5 May 2023
Externally published	Yes

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How do people perceive different advice for rotator cuff disease A content analysis of qualitative data collected in a randomised experimentFinal published version, 820 KBLicence: CC BY-NC

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Zadro, J. R., Michaleff, Z. A., O'Keeffe, M., Ferreira, G. E., Traeger, A. C., Gamble, A. R., Afeaki, F., Li, Y., Wen, E., Yao, J., Zhu, K., Page, R., Harris, I. A., & Maher, C. G. (2023). How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment. BMJ Open, 13(5), 1-10. Article e069779. https://doi.org/10.1136/bmjopen-2022-069779

@article{b37942679ac14c66ae1a993fd9beeb9f,

title = "How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment",

abstract = "Objectives:To explore how people perceive different advice for rotator cuff disease in terms of words/feelings evoked by the advice and treatment needs. Setting:We performed a content analysis of qualitative data collected in a randomised experiment. Participants 2028 people with shoulder pain read a vignette describing someone with rotator cuff disease and were randomised to: bursitis label plus guideline-based advice, bursitis label plus treatment recommendation, rotator cuff tear label plus guideline-based advice and rotator cuff tear label plus treatment recommendation. Guideline-based advice included encouragement to stay active and positive prognostic information. Treatment recommendation emphasised that treatment is needed for recovery. Primary and secondary outcomes:Participants answered questions about: (1) words/feelings evoked by the advice; (2) treatments they feel are needed. Two researchers developed coding frameworks to analyse responses. Results:1981 (97% of 2039 randomised) responses for each question were analysed. Guideline-based advice (vs treatment recommendation) more often elicited words/feelings of reassurance, having a minor issue, trust in expertise and feeling dismissed, and treatment needs of rest, activity modification, medication, wait and see, exercise and normal movements. Treatment recommendation (vs guideline-based advice) more often elicited words/feelings of needing treatment/investigation, psychological distress and having a serious issue, and treatment needs of injections, surgery, investigations, and to see a doctor. Conclusions:Words/feelings evoked by advice for rotator cuff disease and perceived treatment needs may explain why guideline-based advice reduces perceived need for unnecessary care compared to a treatment recommendation.",

author = "Zadro, {Joshua R.} and Michaleff, {Zoe A.} and Mary O'Keeffe and Ferreira, {Giovanni E.} and Traeger, {Adrian C.} and Gamble, {Andrew R.} and Frederick Afeaki and Yaozhuo Li and Erya Wen and Jiawen Yao and Kejie Zhu and Richard Page and Harris, {Ian A.} and Maher, {Christopher G.}",

note = "Funding Information: This study was funded from JRZs National Health and Medical Research Council (NHMRC) Investigator Grant (APP1194105). GEF is funded by an NHMRC Investigator Grant (APP2009808). CGM is funded by an NHMRC Investigator Grant (APP1194283). Publisher Copyright: {\textcopyright} 2023 BMJ Publishing Group. All rights reserved.",

year = "2023",

month = may,

day = "5",

doi = "10.1136/bmjopen-2022-069779",

language = "English",

volume = "13",

pages = "1--10",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "5",

}

Zadro, JR, Michaleff, ZA, O'Keeffe, M, Ferreira, GE, Traeger, AC, Gamble, AR, Afeaki, F, Li, Y, Wen, E, Yao, J, Zhu, K, Page, R, Harris, IA & Maher, CG 2023, 'How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment', BMJ Open, vol. 13, no. 5, e069779, pp. 1-10. https://doi.org/10.1136/bmjopen-2022-069779

TY - JOUR

T1 - How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment

AU - Zadro, Joshua R.

AU - Michaleff, Zoe A.

AU - O'Keeffe, Mary

AU - Ferreira, Giovanni E.

AU - Traeger, Adrian C.

AU - Gamble, Andrew R.

AU - Afeaki, Frederick

AU - Li, Yaozhuo

AU - Wen, Erya

AU - Yao, Jiawen

AU - Zhu, Kejie

AU - Page, Richard

AU - Harris, Ian A.

AU - Maher, Christopher G.

N1 - Funding Information: This study was funded from JRZs National Health and Medical Research Council (NHMRC) Investigator Grant (APP1194105). GEF is funded by an NHMRC Investigator Grant (APP2009808). CGM is funded by an NHMRC Investigator Grant (APP1194283). Publisher Copyright: © 2023 BMJ Publishing Group. All rights reserved.

PY - 2023/5/5

Y1 - 2023/5/5

N2 - Objectives:To explore how people perceive different advice for rotator cuff disease in terms of words/feelings evoked by the advice and treatment needs. Setting:We performed a content analysis of qualitative data collected in a randomised experiment. Participants 2028 people with shoulder pain read a vignette describing someone with rotator cuff disease and were randomised to: bursitis label plus guideline-based advice, bursitis label plus treatment recommendation, rotator cuff tear label plus guideline-based advice and rotator cuff tear label plus treatment recommendation. Guideline-based advice included encouragement to stay active and positive prognostic information. Treatment recommendation emphasised that treatment is needed for recovery. Primary and secondary outcomes:Participants answered questions about: (1) words/feelings evoked by the advice; (2) treatments they feel are needed. Two researchers developed coding frameworks to analyse responses. Results:1981 (97% of 2039 randomised) responses for each question were analysed. Guideline-based advice (vs treatment recommendation) more often elicited words/feelings of reassurance, having a minor issue, trust in expertise and feeling dismissed, and treatment needs of rest, activity modification, medication, wait and see, exercise and normal movements. Treatment recommendation (vs guideline-based advice) more often elicited words/feelings of needing treatment/investigation, psychological distress and having a serious issue, and treatment needs of injections, surgery, investigations, and to see a doctor. Conclusions:Words/feelings evoked by advice for rotator cuff disease and perceived treatment needs may explain why guideline-based advice reduces perceived need for unnecessary care compared to a treatment recommendation.

AB - Objectives:To explore how people perceive different advice for rotator cuff disease in terms of words/feelings evoked by the advice and treatment needs. Setting:We performed a content analysis of qualitative data collected in a randomised experiment. Participants 2028 people with shoulder pain read a vignette describing someone with rotator cuff disease and were randomised to: bursitis label plus guideline-based advice, bursitis label plus treatment recommendation, rotator cuff tear label plus guideline-based advice and rotator cuff tear label plus treatment recommendation. Guideline-based advice included encouragement to stay active and positive prognostic information. Treatment recommendation emphasised that treatment is needed for recovery. Primary and secondary outcomes:Participants answered questions about: (1) words/feelings evoked by the advice; (2) treatments they feel are needed. Two researchers developed coding frameworks to analyse responses. Results:1981 (97% of 2039 randomised) responses for each question were analysed. Guideline-based advice (vs treatment recommendation) more often elicited words/feelings of reassurance, having a minor issue, trust in expertise and feeling dismissed, and treatment needs of rest, activity modification, medication, wait and see, exercise and normal movements. Treatment recommendation (vs guideline-based advice) more often elicited words/feelings of needing treatment/investigation, psychological distress and having a serious issue, and treatment needs of injections, surgery, investigations, and to see a doctor. Conclusions:Words/feelings evoked by advice for rotator cuff disease and perceived treatment needs may explain why guideline-based advice reduces perceived need for unnecessary care compared to a treatment recommendation.

UR - http://www.scopus.com/inward/record.url?scp=85159549247&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2022-069779

DO - 10.1136/bmjopen-2022-069779

M3 - Article

C2 - 37147087

AN - SCOPUS:85159549247

SN - 2044-6055

VL - 13

SP - 1

EP - 10

JO - BMJ Open

JF - BMJ Open

IS - 5

M1 - e069779

ER -

How do people perceive different advice for rotator cuff disease? A content analysis of qualitative data collected in a randomised experiment

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