EHEALTH INTERVENTIONS TO SUPPORT SELF-MANAGEMENT: A QUALITATIVE STUDY EXPLORING PERCEPTIONS AND EXPERIENCES OF PEOPLE WITH MUSCULOSKELETAL DISORDERS AND PHYSIOTHERAPISTS

M. Kelly^1,2, B. Fullen³, D. Martin⁴, C. Bradley⁵, J.G. McVeigh¹

¹Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland, ²Mercy University Hospital, Department of Physiotherapy, Cork, Ireland, ³School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland, ⁴School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom, ⁵Department of General Practice, University College Cork, Department of General Practice, Cork, Ireland

Background: Musculoskeletal disorders (MSDs) are some of the leading causes of disability worldwide. Self-management interventions are recommended as a core component of treatment for people with MSDs. Given limited health care resources, there is increasing interest in the potential role of eHealth interventions to support self-management in this population. The COVID-19 pandemic, described as a “black swan” moment, appears to have been a significant catalyst for the implementation of eHealth modalities into routine practice, providing a unique opportunity for real-world evaluation of this underutilized method of delivering physiotherapy. Hence, an up-to-date exploration of people with MSDs and physiotherapists’ perceptions and experiences of eHealth is warranted.

Purpose: This study explored the perceptions and experiences of eHealth-mediated supported self-management from the perspective of people with MSDs and physiotherapists who work in this clinical area. These views will be used to inform the development and implementation of an eHealth intervention for those with MSDs.

Methods: A qualitative interpretive descriptive approach was taken, and semi-structured telephone interviews were conducted. Participants included both individuals with MSDs and physiotherapists. Participants were recruited using purposive sampling from both public and private physiotherapy services in the Republic of Ireland. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using reflexive thematic analysis. Trustworthiness of the data was established via establishing credibility (e.g. prolonged engagement with the raw data, peer debriefing), along with dependability and credibility (e.g. audit trail and reflective diary).

Results: Three main themes were identified:
1) Flexibility within a blended care model,
2) eHealth as a facilitator of self-management support,
3) Technology: Getting it right.
Physiotherapists and people with MSDs were open to the future use of eHealth interventions within a flexible, blended care model. Participants expressed concerns around assessment and diagnosis, establishing a therapeutic relationship and felt eHealth should be reserved for follow-up purposes. There was a consistent view expressed that eHealth could facilitate aspects of self-management support. A lack of resources and suboptimal user experience remain a challenge.

Conclusions: eHealth interventions in musculoskeletal care were considered broadly acceptable to people with MSDs and physiotherapists as a method for facilitating follow-up self-management support within a flexible blended care model. This study also highlights the importance of continued user involvement to avoid the development of interventions that cannot be used due to time and other constraints.

Funding acknowledgements: This study was funded by the Irish Society of Chartered Physiotherapists (ISCP) COVID-19 Bursary.

Keywords:
eHealth
Self-management
Musculoskeletal pain

Topics:
Musculoskeletal
Pain & pain management

Did this work require ethics approval? Yes

Institution: University College Cork

Committee: Clinical Research Ethics Committee of the Cork Teaching Hospitals.

Ethics number: ECM 4 (j) 20/10/2020