Table 5.

Preliminary General Patient Education Strategies Recommendations for the Management of Subacromial Pain Syndrome (SAPS)

TIDieR items	Recommendations
On WHAT and WHY (Targets of the intervention and its use rationale(s))	The targets for general teaching interventions include: 1. The therapist should systematically discuss with all individuals the importance of physical activity in stimulating the healing process and general activation. 2. The therapist should discuss the rationale for interventions, in terms of their importance for function, to verify the person’s consent to the proposed care and service plan and to promote adherence to the rehabilitation treatment plan. 3. The therapist should act on prevention. (No reason was specified for this recommendation)
With WHAT (Teaching material)	General recommendations on educational material indicate that teaching tools should be used when relevant (e.g., technological equipment [videos, software], technological and telecommunications tools orfollow-up of individuals by email/tele-rehabilitation/telephone, etc.).
HOW (Teaching methods)	1. It is recommended for all teaching situations with this clientele to adopt a general teaching approach which promotes the active participation (empowerment) of the person in their treatment plan and which stimulates their motivation and adherence. This leads to:  a) Insisting on the contribution of the person in their rehabilitation  b) Using personal behaviour change strategies (unspecified)  c) Asking their opinion on what might help them  d) Encouraging them to work collaboratively with the therapist  e) Giving them tools for their self-care at home 2. General recommendations on teaching strategies include:  2.1. Recommendations related to the therapist’s attitude and communication skills:   a) The therapist should pay attention to the choice of words using a positive vocabulary (non-suggestive of injuries) and considering the person’s level of literacy.   b) The therapist should refer to and share their knowledge gained through experience (tacit experience).   c) The therapist should exude confidence in their teachings.   d) The therapist should use an inter/multidisciplinary approach in their teaching by adopting a common message with the other stakeholders, (e.g. relating to medical, pharmacological and rehabilitation treatment), good communication with the care team and avoiding redundancy and/or contradiction.   e) The therapist can reassure the person to avoid anxiety about the condition.  2.2. General recommendations related to the therapeutic relationship and the therapist-person collaboration:   a) The therapist should develop clear, person-centred and related to functioning rehabilitation goals in collaboration with the person and the interdisciplinary team.   b) The therapeutic relationship should allow an alliance with the person, promote active listening, and an honest approach (e.g., in relation to the prognosis)   c) The therapeutic relationship should stimulate the person’s confidence in the therapy (e.g., by explicitly defining roles in therapy)   d) The therapist should discuss the return to work and its benefits in addition to encouraging the person to be proactive towards a return to work.  2.3. General recommendations related to clinical teaching approaches   a) The therapist must enter or clearly record the targets and teaching methods in the physical therapy person’s chart.   b) The therapist must offer individual teaching.   c) The therapist should assess the person’s understanding during and after the teaching (repetition as needed by the therapist, rephrasing by the person, checking the level of understanding between sessions).   d) With the consent of the person, the therapist can involve one or more relatives to share with them the teachings and stimulate social support.   e) The therapist can also offer group education (especially in prevention and in waitlist situations).
WHERE (Location)	No general teaching recommendations for where interventions should be given have been specified for teaching (e.g., clinic, home, or otherwise).
WHEN and HOW MUCH (Times and Quantity)	General recommendations related to when and how much education should be used include: 1. The therapist should set aside time to properly teach. 2. Education must be part of the rehabilitation care of individuals with SAPS and be a priority in almost all cases. 3. Teaching should be used from the first contact with individuals. 4. A maximum of one to three key messages should be presented per session to facilitate learning. 5. Teaching should take a large part of physical therapy treatment.
TAILORING (Adaptations)	General recommendations suggest adjusting to the person and analyzing their learning preferences and profile for teaching by: 1. Letting the person describe their situation in an open manner 2. Documenting and considering their openness and interests 3. Adapting to their capacity for retention and understanding 4. Adjusting to their level of literacy and language barriers (interpreter as needed) 5. Considering their level of anxiety 6. Considering their level of involvement in the treatment plan (e.g., encourage the person to get involved in their therapy or slow it down if they do too much) 7. Adapting to its contextual factors 8. Adapting to the stage of change according to the transtheoretical model 9. Targeting anatomical factors more in the acute phase 10. Targeting psychosocial factors more in the chronic phase