Varahra Azar, MacDermid Joy C, Szekeres Mike, Walton David, Faber Kenneth J
Bruyère Research Institute, Ottawa, Canada.
Health and Rehabilitation Sciences, University of Western Ontario, London, Canada.
Disabil Rehabil. 2023 Oct;45(21):3476-3483. doi: 10.1080/09638288.2022.2134469. Epub 2022 Oct 17.
Proximal humerus fractures are common in older adults and optimizing their outcomes following this injury can be challenging. This study explored recovery from the perspective of individuals who experience proximal humerus fracture.
We conducted in-depth semi-structured interviews ( = 14) with participants (aged 45 and over) recruited from a hand clinic in London, Ontario using a purposive sampling technique. The exploratory interviews were audio-recorded, transcribed, and analyzed using interpretive description approach.
Four themes emerged from the narratives of individuals: challenges of day-to-day activities, coping as you go, recapturing valued life roles, and support matters.
Recovery after PHF seems relative to contexts and manifests within numerous scenarios. Based on individuals' narratives, the context produces a mosaic that contributes to unique recovery perception and experience. Awareness of the context emphasizes the complexity inherent in recovery and may guide healthcare professionals' efforts toward care for their patients.IMPLICATIONS FOR REHABILITATIONIndividuals with proximal humerus fracture experience recovery as a personal and dynamic process occurring in their diverse contexts.Healthcare professionals need to recognize the significant impact of context on individuals' physical, emotional, and social life following proximal humerus fracture (PHF).A multidisciplinary treatment plan might be desirable where people with PHF and health care professionals collaborate as a whole.Building a multidisciplinary health team including healthcare professionals, peer support, and case management may remove some barriers and facilitate the transition to recovery.
肱骨近端骨折在老年人中很常见，优化此类损伤后的治疗效果具有挑战性。本研究从肱骨近端骨折患者的角度探讨康复情况。
我们采用目的抽样技术，对从安大略省伦敦市一家手部诊所招募的参与者（年龄在45岁及以上）进行了14次深入的半结构化访谈。探索性访谈进行了录音、转录，并采用解释性描述方法进行分析。
从参与者的叙述中提炼出四个主题：日常活动的挑战、边康复边应对、重拾重要生活角色以及支持的重要性。
肱骨近端骨折后的康复似乎与具体情境相关，并在多种情形中体现出来。基于参与者的叙述，情境构成了一幅拼图，促成了独特的康复认知和体验。对情境的认识凸显了康复过程中固有的复杂性，可能会指导医护人员为患者提供护理。
对康复的启示
肱骨近端骨折患者将康复视为在其多样情境中发生的一个个人化且动态的过程。
医护人员需要认识到情境对肱骨近端骨折患者身体、情感和社会生活的重大影响。
当肱骨近端骨折患者与医护人员作为一个整体进行协作时，多学科治疗计划可能是可取的。
组建一个包括医护人员、同伴支持和病例管理的多学科健康团队可能会消除一些障碍，并促进向康复的转变。
