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2
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Progressive exercise versus best practice advice for adults aged 50 years or over after ankle fracture: the AFTER pilot randomised controlled trial.渐进性运动与最佳实践建议对 50 岁及以上成年人踝关节骨折后:AFTER 试验的随机对照试验。
BMJ Open. 2022 Nov 24;12(11):e059235. doi: 10.1136/bmjopen-2021-059235.
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Association Between Fear of Falling and Frailty in Community-Dwelling Older Adults: A Systematic Review.社区居住的老年人中跌倒恐惧与虚弱的关联:系统综述。
Clin Interv Aging. 2022 Feb 9;17:129-140. doi: 10.2147/CIA.S328423. eCollection 2022.
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Patients perspective on treatment and early rehabilitation after an ankle fracture: A longitudinal qualitative study.患者对踝关节骨折治疗和早期康复的看法:一项纵向定性研究。
Int J Orthop Trauma Nurs. 2022 Jul;46:100916. doi: 10.1016/j.ijotn.2021.100916. Epub 2021 Oct 29.
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Protocol for the Weight-bearing in Ankle Fractures (WAX) trial: a multicentre prospective non-inferiority trial of early versus delayed weight-bearing after operatively managed ankle fracture.负重踝关节骨折(WAX)试验方案:手术治疗踝关节骨折后早期与延迟负重的多中心前瞻性非劣效性试验。
BMC Musculoskelet Disord. 2021 Aug 9;22(1):672. doi: 10.1186/s12891-021-04560-7.
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Osteoporos Int. 2021 Dec;32(12):2563-2570. doi: 10.1007/s00198-021-06047-6. Epub 2021 Jul 7.
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The meaning of confidence from the perspective of older people living with frailty: a conceptual void within intermediate care services.虚弱老年人视角下的信心意义:中级护理服务中的概念空白。
Age Ageing. 2021 Sep 11;50(5):1802-1810. doi: 10.1093/ageing/afab109.
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Chronic pain with neuropathic characteristics after surgery for major trauma to the lower limb: prevalence, predictors, and association with pain severity, disability, and quality of life in the UK WHiST trial.英国WHiST试验中下肢严重创伤手术后具有神经病理性特征的慢性疼痛:患病率、预测因素及其与疼痛严重程度、残疾和生活质量的关联
Bone Joint J. 2021 Jun;103-B(6):1047-1054. doi: 10.1302/0301-620X.103B.BJJ-2020-2204.R1. Epub 2021 Apr 27.
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A Healing Journey with Chronic Pain: A Meta-Ethnography Synthesizing 195 Qualitative Studies.慢性疼痛的疗愈之旅:综合 195 项定性研究的元民族志。
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Adaptation, self-motivation and support services are key to physical activity participation three to five years after major trauma: a qualitative study.适应、自我激励和支持服务是重大创伤后 3 至 5 年内参与体育活动的关键:一项定性研究。
J Physiother. 2020 Jul;66(3):188-195. doi: 10.1016/j.jphys.2020.06.008. Epub 2020 Jul 14.
10
Patient experiences of an ankle fracture and the most important factors in their recovery: a qualitative interview study.患者对踝关节骨折的体验及其康复过程中的最重要因素:一项定性访谈研究。
BMJ Open. 2020 Feb 4;10(2):e033539. doi: 10.1136/bmjopen-2019-033539.

“这让我感觉自己老了”:了解 50 岁及以上人群踝关节骨折 6 个月时的康复体验。

'It Makes Me Feel Old': Understanding the Experience of Recovery From Ankle Fracture at 6 Months in People Aged 50 Years and Over.

机构信息

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, 6396University of Oxford, Oxford, UK.

Major Trauma Centre, 6396Oxford UniversityHospitals NHS Foundation Trust, Oxford, UK.

出版信息

Qual Health Res. 2023 Mar;33(4):308-320. doi: 10.1177/10497323231153605. Epub 2023 Feb 6.

DOI:10.1177/10497323231153605
PMID:36745107
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10061622/
Abstract

Ankle fracture is a common injury, and depending on injury severity, treatment may be a support boot, cast or surgery. Older people, particularly those with severe injuries who are asked to restrict weight bearing, struggle with early recovery. To elicit older peoples' experience of recovery 6 months after injury, we drew on a phenomenological approach using interviews. Findings revealed that getting on with life was a way of accepting what it feels like to 'be vulnerable', needing to 'be safe' while determinedly working hard to 'be myself'. Being vulnerable identified endurance of inactivity, loneliness and dependency in the non-weight bearing period of recovery, followed by a struggle to weight bear while lacking confidence and being fearful of falling and causing further damage. Being safe conveyed fragility where sensations, pain and stiffness acted as bodily reminders of injury. Lack of function and awareness of danger led to carefulness where planning or curtailing of activities ensured their safety. Being myself showed a determination to push away from a disrupted self-identify of being older or disabled while being challenged by the continuous process of learning to be more mobile. A lack of readiness for old age created a drive to age well. Despite loss of ability, participants hoped to regain their pre-injury way of living. This study challenges practice that disregards the hard work required to recover from ankle fracture. As comorbidity increases with age, failure to consider this aspect may contribute to frailty in this group of older people.

摘要

踝关节骨折是一种常见的损伤,根据损伤的严重程度,治疗方法可能是支撑靴、石膏或手术。老年人,特别是那些因严重受伤而被要求限制负重的老年人,在早期康复方面存在困难。为了了解老年人受伤后 6 个月的康复体验,我们采用了现象学方法,通过访谈进行研究。研究结果表明,“继续生活”是一种接受“脆弱”感觉的方式,需要“安全”,同时坚定地努力“做自己”。脆弱性表现为在康复的非负重期活动耐力下降、孤独和依赖,然后在缺乏信心和害怕跌倒并造成进一步损伤的情况下努力负重。安全性传达了脆弱性,感觉、疼痛和僵硬会让人想起受伤的身体。缺乏功能和对危险的意识导致人们小心谨慎,规划或限制活动以确保其安全。做自己表现出一种决心,远离因受伤而被打乱的自我认同,即年老或残疾的自我认同,同时也面临着不断学习变得更加灵活的挑战。对老年的准备不足会促使人们健康地老去。尽管丧失了能力,参与者仍希望恢复受伤前的生活方式。这项研究挑战了忽视踝关节骨折康复所需的艰苦努力的实践。随着年龄的增长,合并症的增加,如果不考虑这一方面,可能会导致这组老年人的脆弱性增加。