8 How Does Change Unfold in Adolescents with Longstanding Non-Traumatic Knee Conditions after a Consultation? A Repeated Interview Study

Introduction Perceived diagnostic uncertainty emerges during consultations because of miscommunication, potentially leaving adolescents confused and unable to understand ‘what’s wrong with me’. Repeated interviews are a valuable method to facilitate a high-quality, in-depth time-exploration of participants’ experiences and knowledge regarding complex topics. This study aims to explore how adolescents with non-traumatic knee pain experience changes, needs, and understanding of their knee pain over time following a consultation in an orthopaedic department through a series of repeated interviews. Materials and Methods Adolescents aged 10-19 years with non-traumatic knee pain were eligible. We did semi-structured interviews online. The first interview was conducted 1-3 days after the consultation, followed by a second interview 11-17 days after the consultation. Data were analysed using an inductive reflexive thematic analysis by Braun and Clarke, separately in two sprints (timing of interviews). Both time points were synthesized within a matrix, thus completing the final analysis. Results We included ten adolescents with non-traumatic knee pain. The adolescents emphasized the importance of validating their experiences and the significance of social acceptance regarding the existence of ‘knee pain’. Adolescents who were referred for further examinations (e.g., imaging) described a feeling of complete halt in activities and a need to wait for clarification. Lastly, adolescents mentioned experiencing difficulties remembering what was said during the consultation. Conclusion Communication is crucial for maintaining trust and reducing diagnostic uncertainty in adolescents. This underscores the necessity for personalised approaches in medical consultations, considering the unique experiences and understanding of each adolescent.