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Participants who received\n                      <jats:italic>best practice education<\/jats:italic>\n                      more frequently expressed feelings of unhappiness\/frustration. The addition of\n                      <jats:italic>pain science messages<\/jats:italic>\n                      to\n                      <jats:italic>best practice education<\/jats:italic>\n                      resulted in slightly more emotional responses and a greater sense of being validated or cared for. In contrast, participants who received\n                      <jats:italic>structure-focused education<\/jats:italic>\n                      more frequently expressed trust in the clinician\u2019s expertise and the need for medication, activity modification, rest, diagnostic imaging, injections and surgery. These participants also less frequently considered exercise as a viable treatment option.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Participants with rotator cuff-related shoulder pain expressed generally similar emotional responses across groups, with small differences in treatment preferences favouring self-management in the\n                      <jats:italic>best practice education<\/jats:italic>\n                      groups compared with those who received\n                      <jats:italic>structure-focused education<\/jats:italic>\n                      . Those in the\n                      <jats:italic>best practice education<\/jats:italic>\n                      also less frequently reported needing potentially unnecessary treatments (eg, imaging, injections and surgery).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>Australia New Zealand Clinical Trials Registry (ACTRN12623000197639).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107032","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T14:55:28Z","timestamp":1770389728000},"page":"e107032","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Perceptions of best practice, pain science and structure-focused education for rotator cuff-related shoulder pain: a content analysis of qualitative data from a randomised experiment"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5861-2996","authenticated-orcid":false,"given":"Zixin","family":"Zhang","sequence":"first","affiliation":[{"name":"Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia"},{"name":"School of Public Health, Faculty of Medicine and Health, The University of Sydney Institute for Musculoskeletal Health, Camperdown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8534-195X","authenticated-orcid":false,"given":"Giovanni E","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Institute for Musculoskeletal Health, Sydney Local Health District, Camperdown, New South Wales, Australia"},{"name":"School of Public Health, Faculty of Medicine and Health, The University of Sydney Institute for Musculoskeletal Health, Camperdown, New South Wales, 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