医疗专业人员对踝关节骨折手术后患者康复的信念和优先事项：一项定性研究。

Healthcare professionals beliefs and priorities for the rehabilitation of patients after ankle fracture surgery: A qualitative study.

机构信息

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.

School of Medicine, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

出版信息

Injury. 2024 Dec;55(12):111975. doi: 10.1016/j.injury.2024.111975. Epub 2024 Oct 20.

DOI:10.1016/j.injury.2024.111975

PMID:39454293

Abstract

OBJECTIVE

The study aims to understand healthcare professionals' (HCPs) beliefs and practices in the treatment and rehabilitation of patients after ankle fracture surgery, with the goal of informing new rehabilitation interventions based on these insights.

BACKGROUND

There is considerable variation in postoperative rehabilitation advice given to patients with ankle fractures, leading to inconsistent care. Prior studies have primarily focused on patients' experiences, making it crucial to explore HCPs' perspectives to identify areas for intervention.

METHODS

The study utilised semi-structured interviews with HCPs involved in the multicentre randomised controlled Weightbearing in Ankle Fractures (WAX) trial. Interviewees included physiotherapists, consultant trauma and orthopaedic surgeons, and trainee surgeons. Interviews were conducted between February 2020 and December 2021. Data were analysed using a mixed deductive and inductive approach, aligning with the Behavioural Change Wheel framework to translate findings into potential intervention strategies.

RESULTS

18 Interviews were conducted, revealing discrepancies between patient and HCP beliefs about recovery, particularly regarding weight-bearing and managing physical symptoms like swelling and numbness. HCPs expressed varying beliefs on the safety of early weight-bearing and recognised historical practice and medicolegal concerns influencing rehabilitation advice. Themes highlighted the need for clearer communication, standardised advice, and the impact of HCPs' remarks on patients' recovery confidence.

CONCLUSIONS

Findings underscore the mismatch between patient expectations and HCP guidance, emphasising the need for consensus on rehabilitation protocols. The study advocates for tailored rehabilitation pathways that address individual patient recovery trajectories, reduce dependency on HCPs, and encourage patient self-management.

摘要

目的

本研究旨在了解医疗保健专业人员（HCPs）在踝关节骨折手术后治疗和康复患者方面的信念和实践，以期根据这些见解提出新的康复干预措施。

背景

踝关节骨折患者术后康复建议存在相当大的差异，导致护理不一致。先前的研究主要集中在患者的体验上，因此探索 HCP 的观点以确定干预领域至关重要。

方法

本研究采用半结构式访谈，对参与多中心随机对照 Weightbearing in Ankle Fractures（WAX）试验的 HCP 进行访谈。受访者包括物理治疗师、顾问创伤和矫形外科医生以及受训外科医生。访谈于 2020 年 2 月至 2021 年 12 月进行。使用行为改变车轮框架进行数据分析，采用演绎和归纳相结合的方法，将研究结果转化为潜在的干预策略。