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桡骨远端骨折康复期间的职业表现考量:一项范围综述

Considering occupational performance during recovery of distal radius fracture: A scoping review.

作者信息

Bredy Terra M, Glasgow Celeste, Liddle Jacki, Colwell Sally, Holding Jessica, Swan Sarah, Patterson Freyr

机构信息

Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia.

Department of Occupational Therapy, Ipswich Hospital, Ipswich, Queensland, Australia.

出版信息

Aust Occup Ther J. 2024 Oct;71(5):798-832. doi: 10.1111/1440-1630.12965. Epub 2024 May 27.

Abstract

INTRODUCTION

Distal radius fracture (DRF) is one of the most common upper extremity fractures treated by hand therapists and can lead to chronic physical impairment and reduced occupational performance. This scoping review aimed to reveal what is currently known about occupational performance following DRF and to explore if and how occupational performance is defined and considered in the research.

METHODS

This review was guided by the PRISMA-Scoping review and the Joanna Briggs Institute (JBI) guidelines. Relevant databases were searched, and studies that addressed occupation performance in adult participants following DRF were included. The findings were summarised according to the components of occupational performance (person, occupation, and environment), and quality was measured using the Mixed Methods Appraisal Tool.

RESULTS

Forty-three articles met the eligibility criteria for inclusion. All of the studies discussed at least two components of occupational performance, while 25 recognised all three. The consideration of occupational performance was dominated by biomechanical issues associated with the person component (i.e. range of motion, strength). There was some acknowledgement of the psychosocial aspects of the person and, to a lesser extent, the environment, as well as the impact of both on return to occupational performance.

CONCLUSION

Despite occupational performance being at the core of occupational therapy theory, its consideration within the context of research on DRF appears to be focussed on the person component of occupational performance and on biomechanical issues. Further research is recommended to determine how much this reflects current clinical practice and if a more comprehensive consideration of occupational performance will improve rates of recovery following DRF.

CONSUMER AND COMMUNITY INVOLVEMENT

As part of the protocol development for this review, consumers and stakeholders were consulted. They provided feedback on clarity and importance of the research questions.

PLAIN LANGUAGE SUMMARY

A distal radius fracture happens when you break the bone on the thumb side of your wrist. This type of injury often occurs when you fall and land on an outstretched hand. It is one of the more common injuries that hand therapists see in their practice. For some people, recovering from this fracture can take a long time and come with a lot of pain, difficulty moving, and emotional stress. These problems can make it hard to do everyday things like driving, cooking, or getting dressed. It can also affect both paid and unpaid work as well as leisure and social activities, making life more difficult for everyone involved. The findings from this review suggest that the current research usually focuses on how the body physically heals from this type of injury, but it does not pay as much attention to the emotional and social impact on healing. Also, it does not always discuss the activities that are important to the person, or the environment where they live, work, and socialise. This may show a gap in the research regarding our full comprehension of recovery from distal radius fractures. Taking a broader view and approach to recovery, considering a person's emotions, social life, environment, and daily activities, could help people recover fully and get back to their previous life routines and roles after this type of injury.

摘要

引言

桡骨远端骨折(DRF)是手部治疗师治疗的最常见的上肢骨折之一,可导致慢性身体损伤和职业表现下降。本综述旨在揭示目前关于桡骨远端骨折后职业表现的已知情况,并探讨在研究中是否以及如何定义和考虑职业表现。

方法

本综述以PRISMA范围综述和乔安娜·布里格斯研究所(JBI)指南为指导。检索了相关数据库,纳入了涉及桡骨远端骨折后成年参与者职业表现的研究。根据职业表现的组成部分(人、职业和环境)对研究结果进行了总结,并使用混合方法评估工具对质量进行了评估。

结果

43篇文章符合纳入标准。所有研究都讨论了职业表现的至少两个组成部分,而25项研究认可了所有三个组成部分。对职业表现的考虑主要由与人这一组成部分相关的生物力学问题主导(即运动范围、力量)。对人的心理社会方面以及在较小程度上对环境方面有所认识,同时也认识到两者对恢复职业表现的影响。

结论

尽管职业表现是职业治疗理论的核心,但在桡骨远端骨折研究背景下对其的考虑似乎集中在职业表现的人这一组成部分以及生物力学问题上。建议进一步研究以确定这在多大程度上反映了当前的临床实践,以及对职业表现进行更全面的考虑是否会提高桡骨远端骨折后的恢复率。

消费者和社区参与

作为本综述方案制定的一部分,咨询了消费者和利益相关者。他们就研究问题的清晰度和重要性提供了反馈。

通俗易懂的总结

当你手腕拇指一侧的骨头骨折时,就会发生桡骨远端骨折。这种损伤通常发生在你摔倒并伸手着地时。它是手部治疗师在实践中常见的损伤之一。对一些人来说,从这种骨折中恢复可能需要很长时间,而且会伴随着很多疼痛、活动困难和情绪压力。这些问题会使做诸如开车、做饭或穿衣等日常事情变得困难。它还会影响有偿和无偿工作以及休闲和社交活动,给所有相关人员的生活带来更多困难。本综述的结果表明,当前的研究通常侧重于身体如何从这种类型的损伤中愈合,但没有充分关注对愈合的情感和社会影响。此外,它并不总是讨论对个人重要的活动,或者他们生活、工作和社交的环境。这可能表明在我们对桡骨远端骨折恢复的全面理解方面存在研究空白。从更广泛的角度和方法来考虑恢复,考虑一个人的情绪、社会生活、环境和日常活动,可能有助于人们在这种类型的损伤后完全康复并恢复到以前的生活常规和角色。

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