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.

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.