P215 Shoulder stabilisation surgery: Exploring patient satisfaction and barriers to physiotherapy engagement

Published Date: 08th February 2022

Publication Authors: Hodson K

Purpose
Evaluation of physiotherapy provision following elective shoulder stabilisation surgery revealed variation in the number of treatment sessions attended by patients. Patient non-attendance following stabilisation surgery is a recurrent problem and has implications on the success of patient functional outcomes. The aim was to investigate physiotherapy therapeutic satisfaction and identify potential reasons why patients fail to attend appointments and identify areas for improvement.

Methods
Approval was gained from the Clinical Audit Department at the Trust prior to commencing the project. We performed a five hospital, single trust, retrospective review of all elective shoulder surgery patients who were referred into the musculoskeletal physiotherapy service. Patients were referred to the 3 largest physiotherapy departments. Patients who had shoulder stabilisation surgery were telephoned inviting them to attend a patient focus group. We attempted to select patients with low attendances. We ranked patients according to attendance and contacted consecutive patients systematically from lowest to highest rates. We aimed for 12 patients for the focus group with 4 patients having physiotherapy treatment at each department. After contacting 40 patients, 10 agreed to attend with 1 department achieving 4 acceptances and 3 each for the other departments. A questionnaire was constructed with both multiple choice and free-text questions and was sent via patient invitation letter combined with an email reminder. Patients were informed that their information would provide feedback to clinicians anonymously.

Results
60% (6/10) of patients (mean age 24 years, range 19–41) attended the Focus Group. Of the 40% (4/10) of patients who did not attend, 75% (3/4) patients had previously attended only 1 physiotherapy appointment and 25% (1/4) had attended 5 appointments. These 4 patients were subsequently discharged from physiotherapy due to non-attendance. 50% (3/6) of patients were in Higher Education at the time of surgery. 16.7% (1/6) was a manual worker and the only patient that had to stop working prior to surgery due to their shoulder problem. 66.7% (4/6) of patients participated in heavy contact sport i.e. rugby, prior to surgery with only 33.3% (2/6) responding that they were able to return to sport at the same standard. 100% (6/6) were satisfied with physiotherapy information supplied and reported attending all their therapy appointments although 16.7% (1/6) stated that appointment times were not always suitable. Three recurring themes suggested for improvements were, patient written information, sports specific rehabilitation, and flexible appointment scheduling.

Conclusion(s)
Results demonstrated high levels of satisfaction for physiotherapy information and treatment received with some dissatisfaction regarding appointment times. Suggested improvements have been implemented within the physiotherapy service. Despite verbal agreement, 40% (4/10) of selected patients still did not attend the Focus Group. Due to the small sample size and potential selection bias of selecting non-attenders, we cannot draw firm conclusions across this patient cohort. Further work is required to identify the issues relating to patient's engagement to improve attendance.

Impact
At the point of surgical listing, patient information both verbal and written is now provided with emphasis to convey the importance of completing their course of physiotherapy treatment.

 

Birchall, D; Hodson, K; Roy, B. (2022). P215 Shoulder stabilisation surgery: Exploring patient satisfaction and barriers to physiotherapy engagement. Physiotherapy. 114 (Suppl 1), E229-230.

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