Motivation and Barriers to Postoperative Rehabilitation Exercise in Type 2 Diabetic Patients with Rotator Cuff Injuries: A Qualitative Study [Letter]

Dear editor

We thoroughly reviewed the recent article by Zhang and Zhang (2024) titled Motivation and Barriers to Postoperative Rehabilitation Exercise in Type 2 Diabetic Patients with Rotator Cuff Injuries: A Qualitative Study.¹ The qualitative approach offered an in-depth understanding of the psychosocial, emotional, and physiological challenges encountered by type 2 diabetic patients with rotator cuff injuries (T2DM-RCI) patients. Notably, the study emphasizes the role of intrinsic and extrinsic motivational factors—such as personal health goals and social support—in promoting engagement in rehabilitation exercises among T2DM-RCI patients. Furthermore, the study identifies barriers such as fear of pain, lack of knowledge, and limited access to resources, highlighting the necessity of a more holistic approach to postoperative care management. Accordingly, the study suggests that tailored educational interventions and improved communication between healthcare providers and patients could alleviate these barriers, thereby promoting better adherence to rehabilitation protocols. This insight is crucial as it aligns with the increasing recognition of patient-centered care as a cornerstone of effective healthcare delivery.

The selection of research methods is intrinsically linked to the research questions posed. In this study, which focused on the lived experiences of T2DM-RCI patients, the qualitative research methodology was highly appropriate. Qualitative approaches are particularly effective at capturing the nuanced and lived experiences of individuals that quantitative data often fail to represent, particularly in complex scenarios.² Nonetheless, there are aspects that could benefit from further attention in future research. First, qualitative research places significant emphasis on researcher reflexivity.³ Reporting the researcher’s own experiences and providing context regarding their background, such as education and professional expertise, would have been beneficial. This would enhance readers’ understanding of how the researcher arrived at their conclusions, given that responses to the same research question may vary across different specialties. Second, qualitative research highlights the importance of reciprocity in the research process.^4,5 This entails growth for both participants and researchers. For example, it would be valuable to investigate whether T2DM-RCI patients involved in this study gained a deeper awareness of rehabilitation exercises and whether the researcher developed greater empathy and an enhanced ability to support patients in their rehabilitation efforts. This aspect should be addressed in the ethical discussion section. Finally, qualitative research encompasses a diverse range of methodologies, including narrative research, phenomenology, case studies, grounded theory, and ethnography.⁵ A clearer identification of the chosen methodology and the use of more precise terminology would enable readers to better understand the study’s underlying logic.

In summary, this investigation, based on a qualitative research design, provides a comprehensive exploration of the intricate lived experiences of T2DM-RCI. The findings underscore the complex and multifaceted nature of patients’ disease experiences, highlighting the importance of addressing their unique internal and external characteristics. Providing multidimensional support that addresses these specific needs enables healthcare professionals and society to significantly enhance patient outcomes and contribute to a more sustainable future. Ultimately, the insights garnered from this study have profound implications for both individual patient prognoses and broader societal well-being.