Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor - 155 College Street, Toronto, ON, M5T 3M6, Canada.
Osteoporos Int. 2022 May;33(5):1027-1035. doi: 10.1007/s00198-021-06273-y. Epub 2022 Jan 10.
In this qualitative secondary analysis, patients with a fragility fracture described needing informal care post-fracture. A significant proportion reported receiving no care or not enough care, often devising strategies to care for themselves. Requesting help from multiple individuals allowed patients to minimize the burden to family and friends.
In individuals with fragility fractures, our objectives were to examine (1) the experience of receiving informal care post-fracture; and (2) how these care experiences influenced post-fracture recovery and subsequent management of bone health.
A secondary analysis of six primary qualitative studies was conducted. Individuals in the primary studies were English-speaking women and men, 45 years and older, who were living in the community and had sustained a recent fragility fracture or reported a history of previous fragility fractures. Participants who reported at least one instance of needing informal care were categorized as receiving "enough care", "insufficient care", or "no care".
Of 145 participants in the primary studies, 109 (75%) described needing informal care after their fracture. Of those needing care, 62 (57%) were categorized as receiving enough care while 47 (43%) were categorized as receiving insufficient or no care. The care needed affected the management of participants' fracture and bone health, including access to health care services. Participants who received insufficient or no care, especially those living alone, devised strategies to care for themselves and often requested help from multiple individuals to minimize the burden to family and friends. Compared with men, women appeared to report needing help with personal daily activities, such as bathing, and transportation to appointments related to bone health.
Informal care needs are an additional burden of fragility fractures. Post-fracture interventions should consider the broader context of patients' lives and potentially support the care needs of patients as part of their services.
在这项定性二次分析中，脆性骨折患者描述了骨折后需要非正规护理。相当一部分报告称他们没有得到护理或护理不足，通常会想出一些策略来自行护理。向多个个体寻求帮助可以使患者减轻对家庭和朋友的负担。
在脆性骨折患者中，我们的目标是检查（1）骨折后接受非正规护理的体验；（2）这些护理体验如何影响骨折后的恢复以及随后的骨骼健康管理。
对六项主要定性研究进行了二次分析。主要研究中的参与者为英语使用者，年龄在 45 岁及以上，居住在社区，最近发生脆性骨折或报告有先前脆性骨折史。报告至少有一次需要非正规护理的参与者被归类为接受“足够护理”、“护理不足”或“无护理”。
在主要研究中的 145 名参与者中，有 109 名（75%）描述了骨折后需要非正规护理。在需要护理的参与者中，有 62 名（57%）被归类为接受足够护理，而 47 名（43%）被归类为接受不足或无护理。所需的护理影响了参与者骨折和骨骼健康的管理，包括获得医疗保健服务。护理不足或无护理的参与者，特别是独居者，会想出一些自行护理的策略，并且经常向多个个体寻求帮助以减轻对家庭和朋友的负担。与男性相比，女性似乎更需要帮助进行个人日常活动，如洗澡，以及与骨骼健康相关的预约交通。
非正规护理需求是脆性骨折的额外负担。骨折后干预措施应考虑患者生活的更广泛背景，并可能作为其服务的一部分，支持患者的护理需求。
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