Bretherton Christopher P, Kotwal Tejas, Sandhu Harbinder, Baird Janis, Griffin Xavier L
Bone and Joint Health, Blizard Institute, Queen Mary University London, 4 Newark Street, London, E1 2AT, United Kingdom; Department of Trauma and Orthopaedic Surgery, Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, United Kingdom.
Bone and Joint Health, Blizard Institute, Queen Mary University London, 4 Newark Street, London, E1 2AT, United Kingdom.
Injury. 2024 Oct;55(10):111763. doi: 10.1016/j.injury.2024.111763. Epub 2024 Aug 2.
This study investigates patients' experiences of commencing weight-bearing after ankle fracture surgery and their recovery priorities to inform a new rehabilitation intervention.
Embedded within the Weight bearing in Ankle Fractures (WAX) trial, this qualitative study conducted semi-structured interviews with patients following ankle fracture surgery. The Behaviour Change Wheel (BCW) framework guided the interview questions to ensure comprehensive domain coverage. A purposive, maximum variation sampling strategy was used for participant selection. Data analysis employed a combined deductive and inductive approach.
A total of 29 patients were interviewed, revealing five key themes: understanding the recovery journey, navigating the healthcare system, understanding personal physical capabilities, building confidence for weight-bearing, and resuming daily activities. Themes emphasised the variability in healthcare access, the impact of non-weight-bearing on independence, and the role of self-efficacy in recovery.
The study highlighted the diversity in patient experiences and recovery challenges post-ankle fracture surgery. Patients' recovery was influenced by access to consistent healthcare advice, self-efficacy, and the physical and psychological impact of non-weight-bearing. The findings suggest a need for tailored, patient-centred rehabilitation interventions that consider individual recovery trajectories and promote self-management. These insights provide a foundational understanding for developing interventions that more effectively address patient priorities and barriers to recovery.
本研究调查踝关节骨折手术后患者开始负重的体验及其恢复重点，以为新的康复干预提供依据。
本定性研究嵌入踝关节骨折负重（WAX）试验，对踝关节骨折手术后的患者进行了半结构化访谈。行为改变轮（BCW）框架指导访谈问题，以确保全面涵盖各个领域。采用目的抽样、最大变异抽样策略进行参与者选择。数据分析采用演绎法和归纳法相结合的方法。
共访谈了29名患者，揭示了五个关键主题：了解恢复过程、应对医疗保健系统、了解个人身体能力、增强负重信心以及恢复日常活动。这些主题强调了医疗保健获取的差异、不负重对独立性的影响以及自我效能感在恢复中的作用。
该研究突出了踝关节骨折手术后患者体验和恢复挑战的多样性。患者的恢复受到能否获得一致的医疗保健建议、自我效能感以及不负重的身体和心理影响的影响。研究结果表明需要制定以患者为中心的个性化康复干预措施，考虑个体恢复轨迹并促进自我管理。这些见解为开发更有效地解决患者恢复重点和障碍的干预措施提供了基础理解。
