Objective: To explore the facilitators and barriers to implementation of a pilot workplace rehabilitation and global wellness program for orchestral musicians.
Design: Qualitative study comprising focus groups and interviews.Setting: Workplace of conservatory and orchestral musicians and administrators.
Participants: Musicians, administrators and a conductor from two professional orchestras; tertiary-level orchestral students and an administrator from a conservatory of music.
Interventions: We held four focus groups and two interviews to document the perspectives of the participants concerning the implementation determinants of a pilot workplace rehabilitation and wellness program (exercises and health-related education). Meetings consisted of questions based on the Consolidated Framework for Implementation Research. Thematic content analysis was conducted using this same framework, with subcoding according to the Theoretical Domains Framework.
Results: Fourteen musicians and five administrators participated. Results suggest that the implementation determinants for the pilot and future programs rely mainly on the Inner Setting, that is, what musicians refer to as 'the music world', specifically cultural elements such as pain beliefs (e.g. no pain no gain) and lack of resources and time (barriers). Characteristics of Individuals such as social influences amongst colleagues and beliefs about the consequences of self-care or lack thereof, and Intervention Characteristics such as complexity can be facilitators or barriers. All emerging themes have an undercurrent that lies in the Inner Setting.
Conclusion: Musicians' culture, currently a barrier, is a crucial determinant of rehabilitation and wellness program implementation in the orchestral musicians' workplace. A focus on musicians' workplace environment is necessary to optimise implementation and intervention impacts.
Keywords: Rehabilitation program; exercise; implementation; musician; occupational medicine.