Perceived Impacts of Health Care System Navigation on Health and Well-Being Among Patients With Musculoskeletal Conditions: A Qualitative Study
Paige Campbell, Geneviève Jessiman-Perreault, Jean Miller, Romita Choudhury, Kyle McCallum, Jason Martyn, Mel Slomp, Jason Werle, Jill Robert, Breda Eubank, Ania Kania-RichmondBackground
Musculoskeletal (MSK) disorders are a leading cause of disability and health care burden globally. While much research has focused on clinical outcomes, treatment efficacy, and system efficiency, less is known about how challenges in navigating the health care system affect patients’ physical, psychological, and social well-being. Understanding these lived experiences is crucial to informing system-level care improvements.
Objective
To explore patients’ experiences navigating the health care system and the associated impacts on their physical, psychological, and social well-being among individuals with musculoskeletal conditions in Alberta, Canada.
Design
Qualitative study using the interpretive description approach.
Methods
Semi-structured interviews were conducted by telephone with a purposive sample of adult participants who received care for knee (soft tissue), low back (spine), and/or shoulder conditions. Data were analyzed using a framework analytic approach, with particular attention to themes derived from the data related to negative health impacts associated with system navigation.
Results
Seventy-three participants completed an interview. The majority of participants described negative health impacts, which they attributed to challenges navigating the MSK health care system. Patient accounts reveal a spectrum of negative health impacts, including physical health deterioration over and above the MSK condition, a range of mental health challenges, and a decline in social well-being. Participants linked these experiences to specific system-level factors such as delays in receiving care, inconsistency in communications and treatment recommendations, care fragmentation, and affordability barriers.
Conclusions
These findings underscore the challenges of navigating the health system with an MSK condition, which can hinder recovery, exacerbate suffering, and add additional health burdens. Greater attention to the lived experience of system navigation is needed, alongside integrated, timely, person-centred and holistic approaches to MSK care.