What shapes beliefs about persisting symptoms after an isolated extremity injury? A qualitative study

Purpose Injury beliefs can affect how people navigate recovery and influence how they seek treatments. The aim of this study was to explore what influences beliefs about the cause(s) of persisting symptoms after an isolated extremity injury.Methods Data were collected using semi-structured interviews. Participants (n = 12; 67% female) were purposively sampled from a cohort study exploring recovery trajectories after isolated extremity injuries. We used a descriptive approach to reflexive thematic analysis.Results Beliefs were formed through (1) expectations of what recovery entails (2) interactions with trusted others, (3) experience, and (4) prior knowledge and identity (Theme 1 and subthemes 1a–d). Persistent distress was understood as a normal response to an abnormal situation (Theme 2). Causal beliefs were influenced by concerns about judgement from others, particularly when symptoms did not match objective findings (Theme 3).Conclusion Beliefs about the cause of persisting post-injury symptoms can be understood as a network of interrelated beliefs, moulded by individual experience and knowledge, but also interpersonal elements such as therapeutic alliance and fear of not being taken seriously by others. Causal beliefs were sometimes at odds with what patients were told by healthcare professionals, leading patients to seek alternate views.