What factors influence the community's use of physiotherapy services as first-line management for temporomandibular disorders? A qualitative study using the COM-B framework.
Alana Dinsdale, Joni Levine, Shaun O'Leary, Jaqueline Delaney, Jeanne Read, Susana Vuvan, George Dimitroulis, Rory Scanlan, Roma Forbes
Author Information
Alana Dinsdale: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia. Electronic address: alana.dinsdale@uq.edu.au.
Joni Levine: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
Shaun O'Leary: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
Jaqueline Delaney: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
Jeanne Read: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
Susana Vuvan: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
George Dimitroulis: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
Rory Scanlan: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
Roma Forbes: School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
BACKGROUND: Physiotherapists play a unique role within the multidisciplinary management team for temporomandibular disorders (TMDs). However, historically they have been under-recognised and under-utilised in the care of individuals with TMD. To improve TMD management pathways and facilitate uptake of subsequent physiotherapy services, it is important to understand factors which underpin care-seeking behaviours of individuals with TMD in the community. OBJECTIVES: To understand 1) what individuals with TMD perceive the role of physiotherapy to be in TMD management, 2) how these perceptions influence individuals' behaviour in seeking and receiving TMD care, 3) what other factors influence individuals' behaviour in seeking and receiving TMD care from a physiotherapist. DESIGN: Qualitative, grounded in a relativist ontological and constructionist epistemological approach. METHOD: Fourteen individuals with TMD (mean age = 37 years) were purposively recruited and interviewed using a semi-structured framework. Data were analysed deductively using the COM-B framework via a reflexive thematic analysis approach. RESULTS: Data were encapsulated into three themes: 1) motivation, 2) capability and 3) opportunity. Discord between participants' perceptions about TMD and the role of physiotherapists was frequently observed, alongside challenges accessing physiotherapy services due to physical opportunity (e.g. time, financial, geographical, technological) and social opportunity (e.g. connections with and of healthcare practitioners) factors. CONCLUSION: Various intrinsic and extrinsic factors influence individuals' utilisation of physiotherapy services for TMD, including their knowledge about the condition and physiotherapy services available, their social connections, physical opportunity and their motivation to seek help. Promotion of physiotherapy services for TMD should consider these factors to optimise patient care.
