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Development of an optimized framework for delivery of and adherence to exercise-based care for persons with subacromial pain syndrome.

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Title: Development of an optimized framework for delivery of and adherence to exercise-based care for persons with subacromial pain syndrome.
Authors: Poulsen, Lise Kronborg (AUTHOR), Clausen, Mikkel Bek (AUTHOR), Mørkeberg, Claes Johan Peter Weise Schiermer (AUTHOR), Kirk, Jeanette Wassar (AUTHOR)
Source: Disability & Rehabilitation. Jun2026, Vol. 48 Issue 13, p4095-4115. 21p.
Subjects: Evaluation of medical care, Patient compliance, Human services programs, Focus groups, Health attitudes, Research funding, Exercise therapy, Ethnology research, Participant observation, Field notes (Science), Behavior, Sound recordings, Motivation (Psychology), Thematic analysis, Conceptual structures, Field research, Adult education workshops, Content mining, Health behavior, Subacromial impingement syndrome, Data analysis software, Patients' attitudes
Geographic Terms: Denmark
Abstract: Background: Subacromial pain syndrome (SAPS) is a common musculoskeletal condition compromising physical function. Exercise-based care is first-line treatment, but adherence is compromised. This calls for action to optimize the context for clinical pathways to enhance adherence. Purpose: To prioritize and define necessary changes (targets, behaviors, and actions) in the contextual framework and systematically evaluate proposed solutions. Materials and methods: An ethnographic field study employing participatory design to propose actions to facilitate adherence to recommendations. Data were collected in co-design workshops and participant observations. Twelve physiotherapists and medical doctors were recruited as an expert panel to define targets and behaviors and propose actions in workshop 1, and to critically evaluate proposed actions in workshop 2 using the APEASE evaluation criteria and behavior change theories. Results: Targets to enhance adherence to recommendations were: (1) Improved patient motivation for exercise-based treatment, (2) Changing patient beliefs about treatment effects, (3) Changing patient expectations about treatment pathways, and (4) Decreasing complications in cross-sectoral communication. Eight behaviors and corresponding actions to change behaviors were positively evaluated. Conclusion: We identified actions to promote specific behaviors and achieve prioritized targets. The proposed contextual changes may enhance adherence with recommendations and promote optimization of care for people with SAPS. IMPLICATIONS FOR REHABILITATION: A novel approach to solve clinical challenges by examining the context of clinical pathways for patients with Subacromial Pain Syndrome from the clinician's point of view successfully let clinicians design realistic, innovative solutions to tackle complex challenges. The study provides clinicians and organizations with a specific set of actions to help overcome the contextual barriers to guideline adherence in the clinical and political work with patients with Subacromial Pain Syndrome. The theory-based program development approach provided relevant output and seems applicable across conditions. [ABSTRACT FROM AUTHOR]
Copyright of Disability & Rehabilitation is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Development of an optimized framework for delivery of and adherence to exercise-based care for persons with subacromial pain syndrome.
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  Data: <searchLink fieldCode="AR" term="%22Poulsen%2C+Lise+Kronborg%22">Poulsen, Lise Kronborg</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Clausen%2C+Mikkel+Bek%22">Clausen, Mikkel Bek</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mørkeberg%2C+Claes+Johan+Peter+Weise+Schiermer%22">Mørkeberg, Claes Johan Peter Weise Schiermer</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kirk%2C+Jeanette+Wassar%22">Kirk, Jeanette Wassar</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Disability+%26+Rehabilitation%22">Disability & Rehabilitation</searchLink>. Jun2026, Vol. 48 Issue 13, p4095-4115. 21p.
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  Data: <searchLink fieldCode="DE" term="%22Evaluation+of+medical+care%22">Evaluation of medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+compliance%22">Patient compliance</searchLink><br /><searchLink fieldCode="DE" term="%22Human+services+programs%22">Human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Focus+groups%22">Focus groups</searchLink><br /><searchLink fieldCode="DE" term="%22Health+attitudes%22">Health attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise+therapy%22">Exercise therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Ethnology+research%22">Ethnology research</searchLink><br /><searchLink fieldCode="DE" term="%22Participant+observation%22">Participant observation</searchLink><br /><searchLink fieldCode="DE" term="%22Field+notes+%28Science%29%22">Field notes (Science)</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior%22">Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Sound+recordings%22">Sound recordings</searchLink><br /><searchLink fieldCode="DE" term="%22Motivation+%28Psychology%29%22">Motivation (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Conceptual+structures%22">Conceptual structures</searchLink><br /><searchLink fieldCode="DE" term="%22Field+research%22">Field research</searchLink><br /><searchLink fieldCode="DE" term="%22Adult+education+workshops%22">Adult education workshops</searchLink><br /><searchLink fieldCode="DE" term="%22Content+mining%22">Content mining</searchLink><br /><searchLink fieldCode="DE" term="%22Health+behavior%22">Health behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Subacromial+impingement+syndrome%22">Subacromial impingement syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+attitudes%22">Patients' attitudes</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Denmark%22">Denmark</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background: Subacromial pain syndrome (SAPS) is a common musculoskeletal condition compromising physical function. Exercise-based care is first-line treatment, but adherence is compromised. This calls for action to optimize the context for clinical pathways to enhance adherence. Purpose: To prioritize and define necessary changes (targets, behaviors, and actions) in the contextual framework and systematically evaluate proposed solutions. Materials and methods: An ethnographic field study employing participatory design to propose actions to facilitate adherence to recommendations. Data were collected in co-design workshops and participant observations. Twelve physiotherapists and medical doctors were recruited as an expert panel to define targets and behaviors and propose actions in workshop 1, and to critically evaluate proposed actions in workshop 2 using the APEASE evaluation criteria and behavior change theories. Results: Targets to enhance adherence to recommendations were: (1) Improved patient motivation for exercise-based treatment, (2) Changing patient beliefs about treatment effects, (3) Changing patient expectations about treatment pathways, and (4) Decreasing complications in cross-sectoral communication. Eight behaviors and corresponding actions to change behaviors were positively evaluated. Conclusion: We identified actions to promote specific behaviors and achieve prioritized targets. The proposed contextual changes may enhance adherence with recommendations and promote optimization of care for people with SAPS. IMPLICATIONS FOR REHABILITATION: A novel approach to solve clinical challenges by examining the context of clinical pathways for patients with Subacromial Pain Syndrome from the clinician's point of view successfully let clinicians design realistic, innovative solutions to tackle complex challenges. The study provides clinicians and organizations with a specific set of actions to help overcome the contextual barriers to guideline adherence in the clinical and political work with patients with Subacromial Pain Syndrome. The theory-based program development approach provided relevant output and seems applicable across conditions. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Disability & Rehabilitation is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=194641310
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1080/09638288.2025.2590434
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      – Code: eng
        Text: English
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        Type: general
      – SubjectFull: Patient compliance
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      – SubjectFull: Human services programs
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      – SubjectFull: Focus groups
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      – SubjectFull: Health attitudes
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      – SubjectFull: Research funding
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      – SubjectFull: Exercise therapy
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      – SubjectFull: Ethnology research
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      – SubjectFull: Participant observation
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      – SubjectFull: Behavior
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      – SubjectFull: Sound recordings
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      – SubjectFull: Motivation (Psychology)
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      – SubjectFull: Subacromial impingement syndrome
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      – SubjectFull: Data analysis software
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      – SubjectFull: Patients' attitudes
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      – SubjectFull: Denmark
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      – TitleFull: Development of an optimized framework for delivery of and adherence to exercise-based care for persons with subacromial pain syndrome.
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              Text: Jun2026
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