Table 2.
Theme 1: situation of care
| Factor | Description | Patients accounts | Healthcare professionals accounts |
| Clinical status | The healthcare complaint the patient experiences, its stability, reversibility and its impact on the patient in conjunction with other complaints. | If I'm having a flare-up, sometimes I can't even leave the house. I get stuck indoors and I just wouldn't be able to do much really (P7) It was really annoying because it had, like, dislocated, it was dislocated loads before and after to the point that it was really affecting my life. Then I got banned from doing stairs, I couldn’t go out here, I couldn’t go out there, couldn’t really walk anywhere (P5) |
You go back, and then sometimes they make an x amount of improvement, or they have a flare up and then it goes back a bit because they get really stressed out. They're back to that fearful of movement (C7) They're not managing those flare-ups particularly well, so they end up missing classes and things like that. It’s become a bit of a spiral to have that—the physical is having a knock on the mental which is having a knock-on effect on the physical and they're just spiralling out of control (C14) |
| Treatment requirements | The treatment and management of the complaint that is required. The restrictions imposed on the patient. | But after surgery, I was literally bedbound for 3 months, so for 3 months I couldn't do anything (P20) We're just building up my stamina I think at the moment. Not with the hands but with the shoulders. We're just starting slow, building up (P3) So, they've basically come up with a programme for my gym telling me how often I should do it, giving me encouragement saying you're a bit better (P6) |
… building arm strength, stability, muscle patterning, working whole kinetic chain, core stability, lots and lots of gluteal rehab, putting a big emphasis on to their understanding of what’s a good muscle ache and what they should be feeling and what’s working to fatigue rather than what’s working into their pain, and then understanding what’s an okay pain to have, what’s okay to work through, what’s not okay to work through (C11) |
| Care pathway | The availability of healthcare to the patient | On a Skype, are you going to have a half an hour appointment? Or are you just—is it just a check-up to see that you're doing the exercises correctly and they say, right, okay, fine carry on with those? Or that looks really good. So, I think it depends on the time apart, how far you are from the hospital (P2) So if it was once every 3 months, I'd definitely prefer to have—and so, maybe the later stages and everything’s better, then I wouldn't mind having the Skype session, but in terms of the actual rehab and getting from surgery back to performance, I'd definitely like to see a physio (P20) |
…face-to-face slots for me particularly can be—would be really normal to have to wait 6 to 8 weeks for another appointment just because of our system and the vast amount of patients that we have (C15) I think doing it as an adjunct where it’s extra, we just don’t have the capacity for a start, even if it was to (text doing), doing things like that. I think that would be difficult to fit in (C1) At the moment our face-to-faces are an hour. We don’t know that when we do virtual it could be actually much more efficient for us. We could do a really good 30 min telephone consultation and we can actually fit more of them in (C18) |