Wassinger C1, Jones J1, Clayton A1, McGrath J1, Buehler M1, Sole G2
1East Tennessee State University, Physical Therapy, Johnson City, United States, 2University of Otago, Physiotherapy, Dunedin, New Zealand

Background: In the smartphone age patients have unparalleled access to web-based (health) information. The details gleaned from websites are subject to great variability and prone to bias and/or misinformation. At the same time, the importance of psychosocial factors in health is increasingly becoming recognized by physical therapists and other healthcare providers. It remains unclear if the psychosocial components of health are being relayed to patients seeking information on the web.

Purpose: To compare components of web-based information on shoulder pain and its descriptions as biomedical or psychosocial.

Methods: Websites were identified using 5 search terms (shoulder pain, shoulder muscle pain, shoulder impingement, shoulder rotator cuff pain, and shoulder pain diagnosis) across 5 major English-speaking regions (US, Canada, UK, Australia, and New Zealand) using the Google search engine. The top 10 websites for each term and region combination were included. Shoulder specific content was gauged using a shoulder-specific website appraisal tool (SWAT). The SWAT was created for this study with content validated by 3 international experts in shoulder injury research. Primarily biomedical and psychosocial domains were delineated and descriptively compared using the SWAT.

Results: This search protocol resulted in 67 unique websites which were appraised. Greater than 98% of the websites included details with biomedical information whereas less than 3% of websites included any detail regarding psychosocial factors linked to shoulder pain. The most common biomedical aspects included were related to pathoanatomical diagnoses (61 websites) and intervention strategies (53 websites). One website described the role of psychosocial stresses on pain. None of the websites included descriptions on the role of patient beliefs, self-efficacy, or negative coping conditions (fear avoidance or catastrophizing).

Conclusion(s): Patients seeking information from the web regarding shoulder pain are overwhelming presented biomedically oriented information. A biomedical focus may promote health seeking behaviors to that end. Psychosocial factors related to shoulder pain were largely disregarded, thus providing incomplete details regarding shoulder pain. The websites biases toward biomedical information may limit patient self-efficacy in the rehabilitation process.

Implications: Clinicians should be aware of the biomedical leanings of websites and consider patient education that focuses on additional aspects of health, pain, and disability for applicable patients. Website creators should expand shoulder pain related content based on current biopsychosocial understanding of health.

Keywords: health literacy, patient education, biopsychosocial model of shoulder pain

Funding acknowledgements: Internally Funded

Topic: Pain & pain management; Health promotion & wellbeing/healthy ageing; Education

Ethics approval required: No
Institution: East Tennessee State University
Ethics committee: Institutional Review Board
Reason not required: This is not research involving human subjects as defined by the Department of Health and Human Services

All authors, affiliations and abstracts have been published as submitted.

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