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How well do questionnaires on symptoms in neck-shoulder disorders capture the experiences of those who suffer from the disorders?: A content analysis of questionnaires and interviews
University of Gävle, Centre for Musculoskeletal Research. Department of Nursing, Ume̊ University, Umeå, Sweden.
University of Gävle, Centre for Musculoskeletal Research. Alfta Research Foundation, Alfta, Sweden.ORCID iD: 0000-0001-7543-4397
Department of Nursing, Ume̊ University, Umeå, Sweden.
University of Gävle, Centre for Musculoskeletal Research.
2009 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 10, no 1, article id 30Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Previous research has indicated neck-shoulder disorders to have a fluctuating course incorporating a variety of symptoms. These findings awoke our interest to make a comparison between symptoms experienced by people affected with the disorder and the content of questionnaires that assess pain and other symptoms in neck-shoulder disorders. Thus the aims of this study were: -to explore the symptoms experienced by people with non-specific neck-shoulder problems, as well as experiences of nuances and temporal variations (fluctuations) of symptoms; -to investigate which sources were used in the development of ten questionnaires for assessing pain and other symptoms in the neck-shoulder; -to analyse the item content of the questionnaires; -to analyse the correspondence between the item content of the questionnaires and the symptoms described by the informants. METHODS: Content analysis of interviews with 40 people with non-specific neck-shoulder pain, and 10 questionnaires used to assess pain and other symptoms in neck-shoulder disorders. RESULTS: The interviews revealed a variety of symptoms indicating a bodily, mental/cognitive, and emotional engagement, and more general and severe symptoms than are usually considered in neck-shoulder questionnaires. Taking all questionnaires together many of the symptoms were considered, but most questionnaires only included a few of them. The informants were able to distinguish fluctuation of symptoms, and a variety of different qualities which were not usually considered in the questionnaires. Only two questionnaires had made use of the opinions of affected people in the development. CONCLUSIONS: Few of the questionnaires had made use of the experiences of affected people in the development. The correspondence between the symptoms expressed by the affected and the content of the questionnaires was low. A variety of symptoms were expressed by the interviewees, and the participants were also able to distinguish nuances and fluctuations of symptoms. The present study points to the importance of other aspects than just pain and physical functioning as clinical trial outcome measures related to neck-shoulder disorders. To develop a condition-specific questionnaire, it is important to decide on the specific symptoms for the condition. Using the experiences of those affected, in combination with relevant research and professional knowledge, can enhance the validity of the questionnaires.

Place, publisher, year, edition, pages
2009. Vol. 10, no 1, article id 30
Keyword [en]
adult; article; clinical article; clinical feature; cognition; comparative study; content analysis; correspondence analysis; disease severity; female; functional status; human; interview; male; mental disease; musculoskeletal disease; neck malformation; neck shoulder disorder; pain assessment; questionnaire; seasonal variation; validity; disability; health status; health survey; hospitalization; information processing; joint characteristics and functions; lifestyle; middle aged; neck pain; pathophysiology; psychological aspect; shoulder pain
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:hig:diva-4021DOI: 10.1186/1471-2474-10-30ISI: 000265850300001PubMedID: 19272142Scopus ID: 2-s2.0-65349153105OAI: oai:DiVA.org:hig-4021DiVA, id: diva2:209840
Available from: 2009-03-27 Created: 2009-03-27 Last updated: 2018-03-13Bibliographically approved
In thesis
1. Balancing intrusive illness: the experiences of people with musculoskeletal problems
Open this publication in new window or tab >>Balancing intrusive illness: the experiences of people with musculoskeletal problems
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was to explore and describe the health experiences of men and women with musculoskeletal problems. The specific aims of the four papers were: (I) to explore the experience of illness and wellness among ambulance personnel with musculoskeletal symptoms; (II) to explore the experience of illness and wellness among female health care personnel with musculoskeletal symptoms; (III) to explore the experience of bodily illness among people with musculoskeletal problems in the neck-shoulder region, and; (IV) to investigate the symptoms described by people with non-specific neck-shoulder problems, to investigate the method of development of neck-shoulder questionnaires that assesses pain and other symptoms, to analyse the content and items of these questionnaires, and to compare the findings.

The overall findings show that the occupationally active men and women with MSDs were “striving for balance” (I-II), that the disease course of chronic neck-shoulder disorders was characterised by “uncontrollable fluctuations” (III), and that most neck-shoulder questionnaires had a low correspondence to the variety of symptoms experienced during this course (IV). In the process of striving for balance (I-II), the informants’ health experiences were not a state of either wellness or illness, but of both, in varying degrees at different times. The balancing started when illness became too intrusive, and was a process of minimising the impact of illness by accepting and handling it, while attaining and maintaining wellness to feel well enough. When striving for balance, the interviewees kept on working to continue being nurtured at the same time as they made different efforts directed at minimising the impact of their illness. For both men and women, illness was characterised by disembodiment, vulnerability, and exhaustion. The illness experiences were counterbalanced by wellness, where some differences could be recognised between the men and the women. Study III further explored the experiences of bodily illness, focusing on people with chronic musculoskeletal disorders in the neck-shoulder region. The course of the disorder was described as characterised by uncontrollable fluctuations, and it usually developed from insidious symptoms to a state of constant discomfort. The participants experienced calmer periods during the course, but intermittent events of increasing illness were always lying in wait, with periodic moments of consuming intensity. In the interviews included in study IV a variety of symptoms were expressed, which indicated a bodily, mental, and emotional engagement, which included more general and more severe symptoms than are usually related to neck-shoulder disorders. Few of the questionnaires were developed using the experiences of the affected. Taken as a whole, did the questionnaires cover many of the symptoms of the interviewees, but each individual questionnaire only included a few. The fluctuations and nuances of symptoms were rarely considered. The correspondence between individual questionnaires and the experiences of those affected was most often low. This thesis reveals other aspects of health than just bodily experiences as important among occupationally active people with MSDs. It also provides a description of the disease course, and an indication of possibilities for improvement of neck-shoulder questionnaires

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2007. p. 54
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1106
Keyword
musculoskeletal problems, health experiences, illness, wellness, grounded theory, content analysis, balancing, disease course, uncontrollable fluctuations, symptoms
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hig:diva-2741 (URN)978-91-7264-335-2 (ISBN)
Public defence
(English)
Opponent
Supervisors
Available from: 2008-05-27 Created: 2008-05-27 Last updated: 2018-03-13Bibliographically approved

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Wiitavaara, BirgittaBjörklund, MartinDjupsjöbacka, Mats

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