Mohtadi, Nicholas GBlack, Amanda MHunter, Dana Jaclyn2023-05-112022-11-04Hunter, D. J. (2022). Non-Surgical Management of the Medial Collateral Ligament of the Knee: Understanding Adherence to Bracing Treatment (Master thesis). University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca .http://hdl.handle.net/1880/116343https://dx.doi.org/10.11575/PRISM/dspace/41187This thesis used a multimethod study design informed by principals of patient-oriented research to understand the predictors, facilitators, and barriers to adherence to a six-week knee bracing protocol for acute medial collateral ligament (MCL) injuries. The quantitative component aimed to measure adherence to the treatment and explored potential demographic and clinical predictors of adherence (i.e., age, diagnosis, pain, brace satisfaction, overall knee score). The qualitative component used semi-structured interviews with patients to provide an in-depth exploration of barriers and facilitators to brace-wearing. The interview guide and analysis were considered within a postpositivist worldview and were informed by two patient partners with relevant recent experience with non-surgical management of the MCL. Grounded theory was used to inductively create categories, codes, and themes to provide an understanding of brace-wearing adherence. The findings from the quantitative study yielded no significant predictors of adherence at any phase. The qualitative study produced a patient-centered model of brace-wearing adherence and demonstrated how the complex balance between the factors affected patients’ decision to wear the brace. Five core categories were identified to classify the diverse facilitators and barriers to brace-wearing: patient factors, clinical context, treatment factors, injury factors, and external factors. Patient-specific facilitators were crucial to increasing brace-wearing, especially having a strong desire to heal, experience with similar treatments, a good understanding of the purpose of the treatment, being of older age, and using positive coping mechanisms. Other facilitators of brace adherence were identified as positive social support, frequent clinical follow-ups, building effective relationships with clinicians, and higher brace satisfaction (i.e., ease of use and efficiency). Key contributors to reduced brace-wearing adherence were recognized as low treatment satisfaction (i.e., treatment duration and brace discomfort), certain sleeping habits, symptom improvement, and interpersonal hindrances (e.g., negative affect, low resilience, depression, anxiety).Englishpatient-centered careadherencecompliancekneemedial collateral ligamentknee injuryknee bracenonoperative managementnon-surgical treatmentqualitative researchpatient-oriented researchgrounded theory.Health Sciences--GeneralHealth Sciences--Health Care ManagementHealth Sciences--Medicine and SurgeryHealth Sciences--Epidemiologymaster thesis