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‘My hip is damaged’: a qualitative investigation of people seeking care for persistent hip pain
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  1. Beatriz I R de Oliveira1,
  2. Anne Julia Smith1,
  3. Peter P B O'Sullivan1,
  4. Samantha Haebich2,
  5. Daniel Fick2,3,
  6. Riaz Khan3,4,
  7. Samantha Bunzli5
  1. 1 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  2. 2 Hollywood Medical Centre, Hollywood Private Hospital, Nedlands, Western Australia, Australia
  3. 3 Faculty of Science and Engineering, Curtin University, Perth, Western Australia, Australia
  4. 4 School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  5. 5 Department of Surgery, St Vincent’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Beatriz I R de Oliveira, School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia; Beatriz.Oliveira{at}curtin.edu.au

Abstract

Objectives Clinicians who use the biopsychosocial approach to manage musculoskeletal pain disorders aim to understand how patients make sense of their symptoms. Treatment includes targeting the negative beliefs and coping responses that can lead to progressive pain and disability. We aimed to explore how people seeking care for persistent hip pain and disability make sense of their symptoms.

Methods Cross-sectional qualitative study. People were eligible if they were aged ≥18 years, were consulting an orthopaedic surgeon for persistent hip pain and offered a non-surgical intervention. Data were collected through interviews that explored patients’ beliefs about the identity (diagnosis), causes, consequences, timeline and controllability of their symptoms, their strategies to cope with pain and their experiences in seeking healthcare. Transcribed interview data were analysed thematically using a framework approach.

Results Sixteen people (median age=51, range=33–73 years; median duration hip pain=3 years, range=3 months–20 years) participated. Most participants (10/16) believed their pain was caused by an exercise-related injury. Because of the results of imaging and interactions with healthcare professionals, all participants believed they had damaged hip structures. All described ineffective strategies to manage their pain and multiple failed treatments. For many (7/16), a lack of control over symptoms threatened their physical and mental health.

Conclusions The way participants with persistent hip pain and disability made sense of their symptoms contributed to them avoiding physical activity, and it impaired their sleep, emotional well-being and physical health.

  • qualitative
  • hip

http://dx.doi.org/10.1136/bjsports-2019-101281

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    Footnotes

    • Twitter @BeatrizIRdeOli1

    • Presented at This study was presented at the World Confederation for Physical Therapy Congress 2019.

    • Contributors BIRdO, SB, AJS and PPBO designed the study and were involved in drafting and reviewing of the manuscript. PPBO, SH, DF and RK facilitated participant recruitment. BIRdO, SB and AJS analysed and interpreted the data. All authors provided critical revision of the manuscript. All authors take responsibility for the integrity and accuracy of the data in this study. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests PPBO is a Director of Body Logic Physiotherapy but at no time received any funds from the research.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the Hollywood Private Hospital Research Ethics Committee (HPHREC - HPH441) and the Curtin University Human Research Ethics Committee (HR56/2016).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request. Data are in the form of digital voice recordings of interviews, which were also transcribed verbatim into Word files. These data are stored in a password-protected research drive only accessible to the researchers of this study. Voice recordings contain identifiable data and will not be made available on request to maintain participant anonymity. Transcriptions with deidentified participant data may be made available on reasonable request.