Stott-Eveneshen Sarah, Sims-Gould Joanie, McAllister Megan M, Fleig Lena, Hanson Heather M, Cook Wendy L, Ashe Maureen C
The University of British Columbia, Vancouver, Canada.
Freie Universität Berlin, Germany.
Gerontol Geriatr Med. 2017 Mar 20;3:2333721417697663. doi: 10.1177/2333721417697663. eCollection 2017 Jan-Dec.
This study describes patients' perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic), compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups) twice over 12 months. A total of 32 women (64%) and 18 men (36%) participated in the study with a mean age at baseline of 82 (range = 65-98) years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months. Recovering mobility, returning to prefracture activities, and obtaining stable health were the most commonly reported goals. Participants described good social support, access to physiotherapy, and positive perspective as most important to recovery. These factors were influenced by participants' knowledge, resources, and monthly contact with study staff (perceived as a form of social support). The most frequently reported barriers to participants' recovery were the onset of complications, pain, and limited access to physiotherapy. Potential implications of these findings include design and modification of new or preexisting fracture programs, prioritizing patient engagement and enhanced knowledge for future clinical research in hip fracture recovery.
本研究描述了患者在参与一项随机对照试验期间对康复的看法。该试验测试了一种术后髋部骨折管理方案（B4诊所）与常规护理相比对 mobility 的影响。在12个月内对50名髋部骨折的老年人（两组均有）进行了两次半结构化定性访谈。共有32名女性（64%）和18名男性（36%）参与了研究，基线时的平均年龄为82岁（范围=65-98岁）。共有40名参与者在髋部骨折康复的某个阶段报告了康复目标，但只有18名参与者在12个月内实现了目标。恢复活动能力、恢复骨折前的活动以及获得稳定的健康状况是最常报告的目标。参与者表示良好的社会支持、获得物理治疗以及积极的心态对康复最为重要。这些因素受到参与者的知识、资源以及与研究人员每月接触（被视为一种社会支持形式）的影响。参与者康复最常报告的障碍是并发症的出现、疼痛以及获得物理治疗的机会有限。这些发现的潜在影响包括设计和修改新的或现有的骨折方案，在髋部骨折康复的未来临床研究中优先考虑患者参与和增强知识。
