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Table 4 Identified themes of the patient experience from included reviews

From: Patients’ perceptions with musculoskeletal disorders regarding their experience with healthcare providers and health services: an overview of reviews

Patient Experience Outcomes Measure (data collection method) No. of reviews (%) Musculoskeletal disorders Findings
Relational
 Psychological support Survey, questionnaires, interviews, telephone interviews, focus groups, narrative methods, mixed methods 13 (43%) Non-specific low back pain [19, 23, 36, 44], Osteoporosis [39], Rheumatoid arthritis [26, 38], Others [10, 24, 46, 53, 54, 56] Establishes rapport, enables emotional comfort, enables connectedness [10, 38, 44, 46, 53, 54], relieving fear and anxiety, treated with kindness, dignity, compassion and positive attitude [10, 46, 56], emotionally supportive, encouraging and patient-centered healthcare [19, 24, 36, 46], potential psychological and social consequences of the diagnosis [39], knowing you can get help when you need it is important [39], previous negative experiences with medical consultations [26], ethical practice [23]
 Understanding (patient expectations) Survey, questionnaire, interviews, telephone interviews, focus groups 18 (60%) Non-specific low back pain [19, 23, 37, 41, 47, 49, 50, 52], Osteoporosis [21, 39], Osteoarthritis [40], Rheumatoid arthritis [26], Others [10, 24, 48, 51, 53, 56] Respect, being listened to, empathy, mutual understanding [10, 19, 23, 26, 37, 39, 48,49,50,51, 56], getting to know the patient [24, 49], Taking patient opinion and preference into consideration [21, 23, 41], desirable characteristics of the medical practitioners (being non-judgmental, non-egotistical with an open interested attitude and mind, honest about his/her limitations and reflective of his/her own behavior and emotions, friendly, supportive, considerate, patient, genuine, polite, positive, caring for the patient, the ability to care for the patient, taking the patient seriously, believing in the patient, recognition of the patients’ emotions, making a commitment to the patient, and making the best effort, enables connectedness, punctual, reliable, transparent, open to second opinion, fully informing, and welcomes questions) [21, 23, 24, 47, 53], expectation of treatment (participants had negative perceptions of surgery because of the associated risks, previous positive or negative experiences with physiotherapy and their treatment of their clinical condition) [40, 53], expectation of condition (Patients have the perception that “there are probably people worse off” and they should have priority for surgery) [40], Congruent patients experienced more pain relief and effectiveness of the treatment than noncongruent patients [50]., Patients believed that physiotherapy-delivered care helped with pain relief, facilitated a better understanding of pain management strategies, prevented worsening of low back pain and improved mobility and function [52], Chiropractic therapy was perceived by some patients to be effective; however, others were concerned about adverse outcomes [52].
 Information needs (education) Cross-sectional surveys, questionnaire, interviews, telephone interviews, focus groups, diaries, video recording 24 (80%) Non-specific low back pain [19, 20, 23, 36, 37, 41, 44, 47, 49, 50], Osteoporosis [21, 39, 45], Osteoarthritis [20, 22], Rheumatoid arthritis [26, 38, 42], Others [10, 24, 51, 53, 54, 56] Patients’ perceived need to obtain health information from a variety of sources and health information content about the diseases [19, 20, 25, 36, 38, 44, 45, 54], perceived needs for imaging for diagnostic purposes and legitimation of symptoms [20, 36, 50], explaining the patient’s condition such as possible symptoms and cardiovascular risks and educating the patient about treatments, self-management strategies and physical exercises [10, 22,23,24, 36, 38, 39, 41, 42, 45, 47, 49,50,51,52,53,54, 56], reasons for seeking health information, delivery modes and barriers to meeting health information needs [36, 37, 42], information needs and concerns about medications [20,21,22, 38, 45], clear, comprehensive information that raises awareness of available options, risks, and benefits of treatments [10, 54], lack of information enhance worries [39], a minor health concern using the comparison to gain a sense of osteoporosis [39], patients with low back pain sought healthcare from medical practitioners to obtain a diagnosis, receive management options, sickness certification and legitimation for their low back pain. However, there was dissatisfaction with the cursory and superficial approach of care [20], patients’ perceived need of invasive therapies (patients avoided injections and surgeries) [20], Desired information content was broad, and included targeted and practical information covering disease treatment and psychosocial wellbeing [42], written and verbal information [45], necessity of diagnosis [47], patients’ need to gain information by sharing experiences with other patients [26], understanding the prognosis [54], specific information, tailored to their condition, rather than generalities [54]
 Shared decision-making (patient involvement and engagement) Survey, questionnaire, interviews, telephone interviews 12 (40%) Non-specific low back pain [19, 23, 37, 50], Osteoarthritis [40], Rheumatoid arthritis [26], Others [10, 24, 48, 51, 54, 56] Shared decision-making [19, 26, 50, 51, 53, 54], patient involvement [37], patient engagement (Fully informed, provided with test results, prognosis explained, given self-help strategies, preventative strategies, home program, responds to feedback, choice of provider, choice of treatment, communication with other care providers/health professionals, play an active role in their management) [23, 48, 54, 56], patient empowerment [24](8), Involvement of, and support for family and caregivers in decisions [10, 23, 48], Working with patient-defined goals [24, 48], symptoms and information sources were the two main factors influencing patient decision-making [40], partnership of care [53]
 Communication Survey, questionnaire, interviews, telephone interviews, dairies 16 (53%) Non-specific low back pain [19, 36, 37, 41, 47, 49, 50], Osteoarthritis [22], Rheumatoid arthritis [26, 43], Others [10, 24, 51, 53, 54, 56] Good communication skills [19, 22, 26, 37, 49,50,51, 53, 54, 56], language and tone used [36], transparency, honesty, disclosure when something goes wrong [10], continuous tailored communication in lay speech [24], non-verbal communication [24], interpersonal skills: listening, empathy, friendliness, encouragement, confidence [41, 43, 47]
Functional
 Effective, individualized treatment Survey, questionnaire, interviews, telephone interviews, diaries 12 (40%) Non-specific low back pain [37, 41, 47, 49, 50, 52], Osteoarthritis [22], Rheumatoid arthritis [43], Others [10, 24, 51, 53] Individualized, patient-centered care [22, 24, 37, 41, 47, 49, 51, 52], Timely, tailored and expert management of physical symptoms [10, 51], achieving normalcy and wellness maintenance, complete recovery, pain control and desirable outcomes [43, 50, 53], expectations for pharmacological treatment that involved decreased side effect [43], perceived needs for choice of treatment options such as pharmacologic therapy and pain management methods, complementary and alternative medicine (CAM), joint replacement surgery, orthoses and physical aids [22] Pain relief can be regarded as the driving force for seeking treatment or for returning for subsequent treatment [50].
 Trusted expertise Cross-sectional surveys, questionnaire, interviews, telephone interviews, diaries, video recording, focus groups 16 (53%) Non-specific low back pain [19, 23, 37, 41, 47, 50], Osteoporosis [21, 45], Osteoarthritis [22, 40], Rheumatoid arthritis [38], Others [10, 24, 46, 53, 54] Perception of the health professionals’ role [40, 54], qualifications, competence, and technical skills [19, 22, 23, 46, 53], physical therapist practical skills, expertise, knowledge, and training [24, 41], perceived physician knowledge and attitudes and beliefs [45], patients’ perceived needs of investigations for diseases [21, 50], the need for thorough assessment and holistic care [19, 22, 50], the need for a diagnosis and finding a cause of pain [19, 50], trusted professionals [10, 47], role of the health professionals as being important in helping them find solutions to cope with their pain, holding them accountable for pain management [37], validation by the multidisciplinary panel [38], confidence [24, 50]
 Physical and environmental needs (social support) Survey, questionnaire, interviews, diaries 16 (53%) Non-specific low back pain [23, 36, 41, 44], Osteoporosis [45], Osteoarthritis [22, 40], Rheumatoid arthritis [26, 38, 42, 43], Others [10, 48, 51, 53, 54] Social connectedness, context and social support [36, 38, 43,44,45, 53], organizational factors, time, flexibility and simplicity with patient appointments and care [23, 41, 48, 53], attention to physical support needs and environmental needs (ex. clean, safe, comfortable, accessible environment) [10, 23, 26, 48, 51, 53, 54], convenient clinic hours, location, and parking, as well as available and approachable support staff [23, 51], practical support needs of adaptive workplace, living environment modification and coping strategies on how to continue daily activities and manage social roles by using assistive devices or aids [22, 23, 38, 54], the total knee replacement outcome was viewed positively or negatively when viewed concerning the participant’s life context or environment [40], group sessions had advantages for psychosocial issues while written information provided useful supplementation [42], financial and time cost [22, 51]
 Continuity of care Survey, questionnaire, interviews, diaries 13 (43%) Non-specific low back pain [19, 37, 41, 44, 47, 50], Osteoarthritis [22], Rheumatoid arthritis [26, 42], Others [10, 46, 51, 55] Feasibility and availability of healthcare service [37, 44], coordination and continuity of care; smooth transitions from one setting to another (patients and their caregivers may experience a lack of clarity about where clinical responsibilities ended and caregiver responsibilities began) [10, 19, 46, 47, 50, 55], the need for collaboration between different HCPs, confusion about the role of different healthcare providers [19, 55], time length of consultations and flexibility with patient appointments and care [26, 41, 50], barriers to meeting health information needs were around timely access [42], preferences for follow-up care [26, 51], timing and accessibility of appropriate care and in times of need [26], need for allied health and CAM [26], disorganized discharge planning (a focus on rapid discharge, absence of patient and caregiver involvement during discharge planning and a lack of standardized patient assessment during care transitions) [55], lack of information sharing with patients and caregivers included an absence of the following: healthcare providers-initiated conversations about treatment plans, accurate information about the recovery and information from hospital staff during discharge and admission [55].
 Privacy Survey, questionnaire 3 (10%) Non-specific low back pain [23], Others [48, 51] Respect for patient privacy [23, 48], lack of privacy will lead to less patient satisfaction [51]