Patients' experiences of flexor tendon rehabilitation in relation to adherence: a qualitative study

Purpose To explore patients' experiences of early active motion flexor tendon rehabilitation in relation to adherence to restrictions and outcome of rehabilitation. Method Seventeen patients with a flexor tendon injury in one or several fingers participated in qualitative interviews performed between 74 and 111 days after surgery. Data were analysed using directed content analysis with the Health Belief Model (HBM) as a theoretical framework. Results Perceived severity of hand function and susceptibility to loss of hand function affected the participants' behaviour. A higher perceived threat increased motivation to exercise and be cautious in activities. During rehabilitation, the perceived benefits or efficacy of doing exercise and following restrictions were compared to the cost of doing so, leading to adherence or non-adherence behaviour. Perceived self-efficacy was affected by previous knowledge and varied through the rehabilitation period. External factors and interaction with therapists influenced the perception of the severity of the injury and the cost and benefits of adhering to rehabilitation. Conclusion Patient's perception of the injury, the effectiveness of exercises, context and social support to manage daily life affected adherence to restriction, motivation and commitment to rehabilitation. The HBM as a theoretical framework can be beneficial for understanding factors that influence patients' adherence.

Automated summary

The purpose of this study was to explore patients' experiences of early active motion flexor tendon rehabilitation in relation to adherence to restrictions and outcome of rehabilitation. The results showed that patients' perception of the severity of hand function and susceptibility to loss of hand function affected their behavior. The perceived benefits or efficacy of exercise and following restrictions were compared to the cost of doing so, leading to adherence or non-adherence behavior. Perceived self-efficacy was influenced by previous knowledge and varied during the rehabilitation period. External factors and interaction with therapists influenced the perception of the severity of the injury and the cost and benefits of adhering to rehabilitation.