Self-management of a musculoskeletal condition for people from harder to reach groups: a qualitative patient interview study

Jo Adams*, Wendy Lowe, Joanne Protheroe, Jill Lueddeke, Ray Armstrong, Cynthia Russell, Don Nutbeam, Claire Ballinger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)
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Background: This study recorded the functional health literacy levels of people with musculoskeletal (MSK) conditions from harder to reach groups and explored their experiences in engaging with health care professionals to self-manage their MSK condition. Methods: We recruited participants, identified by key health and social care contacts as likely to have lower health literacy levels, and used semi-structured interviews to collect data. Thematic analysis was used to identify the main key themes arising from the transcribed interviews. Results: Eighteen participants were identified and recruited from harder to reach community populations, 10 were scored as having inadequate functional health literacy on the Short Form Rapid Estimate of Adult Literacy Measure. Three themes were identified in relation to participants’ experiences of MSK self-management approaches: engaging with health care services; interpreting the health care providers’ message; and facilitating participation in MSK self-management. Conclusions: Our findings indicate that people with a MSK condition, from harder to reach groups, experience multi-morbidity, find health care systems complicated and hear from health care professionals that their MSK condition cannot be cured. People interpreted that a lack of cure meant that nothing could be done to help their MSK pain. Engaging with self-management strategies was not seen as a priority for our participants. Strategies to simplify health communication, more time to process health information and supportive social networks helped our participants to understand and manage their MSK health on a day-to-day basis. Implications for Rehabilitation MSK conditions are long term and prevalent in the UK with substantial impact on people’s daily life. Currently self-management strategies for MSK conditions are poorly communicated and many patients believe that nothing can be done to help their MSK pain. Good clinician communication that supports self-management is needed so that key messages can be effectively understood and used by patients with a range of literacy skills. Health services need to be even more accessible to help all individuals from a range of backgrounds better self-manage their MSK conditions.

Original languageEnglish
Pages (from-to)3034-3042
Number of pages9
JournalDisability and Rehabilitation
Issue number25
Early online date28 Oct 2018
Publication statusPublished - 2019

Bibliographical note

Funding Information:
This work was funded by Arthritis Research UK [Grant ref 19623)]. We would like to thank Dr Sarah Ryan and Dr Tom Margham for help in recruiting participants and for all the study participants and their time.


  • accessible
  • arthritis
  • communication
  • experience
  • Joint pain


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