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The management experiences, needs and preferences of individuals seeking care for persistent intra-articular temporomandibular disorders: a qualitative study.

BACKGROUND
Little is known about the management experiences, needs and preferences of individuals seeking care for persistent intra-articular temporomandibular disorders (TMD). Investigating these experiences may improve understanding of the impact management has on individuals, and factors that shape these experiences. This information may advance current practice and guide future management of individuals with intra-articular TMD.


OBJECTIVES
To investigate the management experiences, needs and preferences of individuals with persistent intra-articular TMD.


METHODS
A qualitative study was performed. Thirteen eligible participants (mean age 32.7 years, 12 female) were recruited via purposive sampling, and interviewed using a semi-structured framework. Data were analysed using a thematic analysis approach.


RESULTS
Four themes were established from interview data: i) Searching for help; ii) Wanting answers; iii) Wanting to regain control; and iv) Meeting needs, preferences and expectations, and the implications on care. Numerous factors influenced the experiences of those seeking care, including the ability to navigate care and management expectations. Specific to intra-articular TMD, the absence of pain made seeking care harder, and often patients perceived neglect of mechanical symptoms by healthcare practitioners which negatively impacted care. Often, those wanting management expressed the need for answers and to regain control over their jaw symptoms.


CONCLUSIONS
Strategies to improve healthcare navigation are needed for those wanting help for intra-articular TMD. Within management, a person-centred approach is encouraged. Practitioners should respect individuals' specific needs and preferences, and address underlying management expectations, to facilitate positive care experiences. Consideration of symptoms other than pain in intra-articular TMD populations is paramount.