Patient-Reported Outcome Measures and Self-Management Strategies to Promote Health in Higher-Education Classical...

Students in classical music performance in higher education frequently report playing-related musculoskeletal disorders (PRMDs) and psychological distress. Observational studies based on self-reported data suggest an association between these two health problems. This observation supports early multidimensional prevention. However, access to musician-specific health support remains limited. The aim of this study was to develop a consensus among experts, informed by input from music students and teachers (stakeholders), on the relevance/usefulness of Patient-Reported Outcome Measures (PROMs) and self-management strategies for music students, structured across four target domains: physical, psychocognitive, behavioral, and professional. A secondary aim was to identify relevant health-knowledge content and pedagogical modalities for prevention within the music curriculum.

A Delphi study was conducted according to the Guidance on Conducting and Reporting Delphi Studies (CREDES) guidelines. The Delphi survey items were derived from a previous scoping review, which identified 42 PROMs and 97 self-management strategies for pre¬professional and professional musicians, and from relevance/usefulness ratings provided by music students and teachers. In Round 1, experts rated each item's relevance/usefulness on 5-point Likert scales. In Round 2, retained items and refined additional proposals were re-rated; consensus was defined as ≥50% of experts ranking an item among the top 50% most relevant/useful within their individual set of rated items.

Fourteen experts participated in Round 1 (4 clinicians, 2 researchers, 8 clinician-researchers) and 12 in Round 2. After two rounds, experts reached consensus on 10 PROMs, 30 self-management strategies (e.g., advice on physical exercise, individual work organization, and balance/postural control exercises), and 7 health-knowledge topics, spanning physical, psychocognitive, behavioral, and professional domains. Experts supported structured, curriculum-embedded delivery and formal academic credit at both Bachelor's and Master's levels.

Numerous self-management strategies are considered relevant for improving health management in the daily lives of music students. The results highlight strong consensus in favor of incorporating PROMs-based health monitoring, health knowledge, and self-management strategies into higher-education music curricula to support music students' health management in daily life across physical, psychocognitive, behavioral, and professional domains.