Southwell Jessica, Potter Chris, Wyatt David, Sadler Euan, Sheehan Katie Jane
School of Population Health and Environmental Sciences, Kings College London, London, UK.
Guy's and St Thomas's NHS Foundation Trust, London, UK.
Disabil Rehabil. 2022 Mar;44(6):940-947. doi: 10.1080/09638288.2020.1783002. Epub 2020 Jul 1.
To explore older adult's perceptions of early rehabilitation and recovery after hip fracture, as a complement to the UK standards for acute physiotherapy after hip fracture.
In-depth semi-structured interviews with 15 adults aged 60 years or more in hospital after hip fracture surgery. A thematic analysis approach with interpretation informed by Bury's biographical disruption theoretical framework.
Participants voiced the importance of self-determination, professional support, meaningful feedback, and social capital after hip fracture. Collaborative working with staff was required for meeting the UK standards. Participants voiced anxieties about their hip fracture when considered in conjunction with their age and co-existing conditions, anticipating a disruption to their previous physical and social activities. This new, more dependent, life situation was not acceptable to participants.
This study suggests hip fracture alone, was not perceived as a biographical disruption by older adults although it is presented as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions. For successful implementation of the UK standards, goal setting should consider patients in the wider context of their advancing age and co-existing conditions to empower them to define a fresh narrative of self.Implications for rehabilitationHip fracture was perceived as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions.Participants expressed uncertainty over their ability to recover their previous identity in the absence of professional support and/or social capital.Healthcare professionals need to educate and empower older adults to take charge of their own recovery.For successful implementation of the UK standards for acute physiotherapy, there is a need to contextualize goal setting to empower patients to define a fresh narrative of self.
探讨老年髋部骨折患者对早期康复及恢复的看法，作为英国髋部骨折后急性物理治疗标准的补充。
对15名60岁及以上髋部骨折手术后住院的成年人进行深入的半结构化访谈。采用主题分析方法，并依据伯里的传记中断理论框架进行解读。
参与者表达了髋部骨折后自主决定权、专业支持、有意义的反馈和社会资本的重要性。为达到英国标准，需要与工作人员协作。考虑到年龄和并存疾病，参与者对髋部骨折表示焦虑，预计之前的身体和社交活动会受到干扰。这种新的、更依赖他人的生活状况参与者无法接受。
本研究表明，尽管髋部骨折被视为独立性丧失的潜在转折点，会导致因年龄增长和并存疾病造成更广泛的干扰，但老年人并不认为单纯的髋部骨折会造成传记中断。为成功实施英国标准，目标设定应在老年人年龄增长和并存疾病的更广泛背景下考虑患者，以使他们能够重新定义自我。康复的意义髋部骨折被视为独立性丧失的潜在转折点，会导致因年龄增长和并存疾病造成更广泛的干扰。参与者表示，在缺乏专业支持和/或社会资本的情况下，他们不确定能否恢复以前的身份。医疗保健专业人员需要教育老年人并赋予他们自主康复的能力。为成功实施英国急性物理治疗标准，有必要将目标设定置于具体情境中，以使患者能够重新定义自我。
