"I had already tried that before going to the doctor" - exploring adolescents' with knee pain perspectives on 'wait and see' as a management strategy in primary care; a study with brief semi-structured qualitative interviews

Objectives: The aim of this study was to examine how the "wait-and-see" recommendation affects adolescents' understanding of their illness and symptoms and their care-seeking behavior. Methods: This study included brief qualitative, semi-structured online interviews. Adolescents (age 10-19 years) with long-term knee pain, who had been recommended "wait-and-see" by their general practitioner (GP), were recruited via previous studies and social media. Two researchers conducted brief semi-structured interviews through Microsoft Teams. An interview guide with open questions was created prior to the interviews and updated as new questions emerged. The extracted data was transcribed and analyzed via a reflexive thematic approach in NVivo. Results: Eight adolescents (mean age 17.8) with long-standing or recurrent knee pain (mean duration 3.5 years) were included. The analysis identified four main themes: (1) The perception of wait and see over time, (2) The GP's acknowledgement and consideration, (3) experienced limitation from knee pain and (4) the importance of getting a diagnosis. The perception of "wait-and-see" approach changed from positive to negative when adolescents received the recommendation multiple times. Adolescents experienced frustration with their situation and a lack of consideration from their GP made them cautious about seeking additional care. Knee pain significantly limited the adolescents' physical-and social activities. Receiving a diagnosis was important and helped adolescents dealing with their pain. Conclusions: The connotation of wait-and-see changed from positive to negative for adolescents when receiving the recommendation multiple times. The participants felt getting a clinical diagnosis was a relief. Furthermore, the lack of consideration and acknowledgement from the GP plays an essential role in the adolescent's understanding of their knee pain.