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

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: 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.