Department of Anaesthetics, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom.
PLoS One. 2023 May 18;18(5):e0285980. doi: 10.1371/journal.pone.0285980. eCollection 2023.
It is well recognised that hip fracture surgery is associated with a negative impact on short and long-term post-operative physical health and emotional well-being for patients. Furthermore, these patients are known to be frail with multiple co-morbidities. This study explores how frailty shapes the lived experiences of rehabilitation and recovery for patients who have undergone hip fracture surgery. Semi-structured interviews were conducted with sixteen participants, recently discharged from hospital following hip fracture surgery. Interpretative phenomenological analysis was applied to explore the lived experiences of frail patients and ascertain important themes. Patient experiences were captured in seven overarching themes: 1) the hospital as a place of "safety", 2) placing trust in others, 3) the slow recovery journey impeded by attitude and support, 4) maintaining autonomy and dignity whilst feeling vulnerable, 5) seeking a new normal, 6) loneliness and social isolation and 7) the ageing body. Based on our study findings, we have been able to suggest a number of opportunities to improve support for frailer patients in finding a new routine to their everyday lives, these include on-going physical and psychological support, information and education and a robust pathway for transition of care into the community. A conceptual thematic diagram is presented which helps to understand the experience and the complex needs of frail older people undergoing hip fracture surgery.
众所周知,髋部骨折手术会对患者的短期和长期术后身体健康和心理健康产生负面影响。此外,这些患者身体虚弱,患有多种合并症。本研究探讨了虚弱如何塑造髋部骨折手术后康复的患者的生活体验。对 16 名最近从医院出院的髋部骨折手术后患者进行了半结构化访谈。应用解释现象学分析来探索脆弱患者的生活体验,并确定重要主题。患者的体验被捕捉在七个总体主题中:1)医院是一个“安全”的地方,2)信任他人,3)态度和支持阻碍了缓慢的康复过程,4)在感到脆弱的同时保持自主和尊严,5)寻求新的常态,6)孤独和社会隔离,7)衰老的身体。基于我们的研究结果,我们提出了一些机会,可以为更脆弱的患者提供支持,帮助他们找到日常生活的新规律,包括持续的身体和心理支持、信息和教育以及将护理顺利过渡到社区的健全途径。本文呈现了一个概念性主题图,有助于理解身体虚弱的老年人接受髋部骨折手术后的体验和复杂需求。