May Pauline, Davies Firoza, Yeowell Gillian, Littlewood Chris
Integrated Musculoskeletal, Pain and Rheumatology Service (IMPReS), East Lancashire Hospitals NHS Trust, Burnley, United Kingdom.
Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom.
PLoS One. 2024 Dec 31;19(12):e0316516. doi: 10.1371/journal.pone.0316516. eCollection 2024.
Shoulder fractures (proximal humerus fractures) are common, painful, debilitating injuries. Recovery is a long process often hindered by complications such as mal-union and frozen shoulder. The purpose of this qualitative study was to explore the experiences and information needs of people at different time points after a shoulder fracture and how views on recovery change over time.
This longitudinal telephone interview study used a semi-structured approach based on a pre-planned interview topic guide. Recruitment was from June to November 2023. Participants were interviewed approximately two months and five to six months after their injury. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.
14 participants were recruited (age range 44-80 years; three male). The themes identified were dependence, vulnerability, information needs, and recovery. Loss of function and identity were associated with dependence. Feelings of vulnerability were present for most participants at six months post-injury. Information needs evolved, with information about the extent of the injury and practical advice needed first, but later participants emphasized the importance of reassurance and expected timelines for recovery. Recovery meant regaining function and independence, and returning to meaningful activities, which was also not fully achieved for most participants by six months.
This study is the first to explore information needs and experiences along the timeline of recovery from a shoulder fracture. What recovery means to individual patients, along with recognition of the extent to which feelings of vulnerability affect recovery are important factors to consider. Clinicians should be aware of the full impact of these injuries to guide patients on their recovery journey, including identifying feelings of vulnerability and regaining their identity. Adopting a person-centred care approach, and considering the changing priorities and information needs of patients throughout their recovery journey may lead to improved patient care.
肩部骨折（肱骨近端骨折）是常见、疼痛且使人虚弱的损伤。恢复是一个漫长的过程，常因诸如畸形愈合和肩周炎等并发症而受阻。这项定性研究的目的是探讨肩部骨折后不同时间点人们的经历和信息需求，以及恢复观念如何随时间变化。
这项纵向电话访谈研究采用基于预先计划的访谈主题指南的半结构化方法。招募时间为2023年6月至11月。参与者在受伤后约两个月以及五到六个月接受访谈。访谈进行录音并逐字转录。数据采用主题分析法进行分析。
招募了14名参与者（年龄范围44 - 80岁；三名男性）。确定的主题为依赖、脆弱性、信息需求和恢复。功能和身份的丧失与依赖相关。大多数参与者在受伤后六个月时存在脆弱感。信息需求不断演变，首先需要有关损伤程度的信息和实用建议，但后来参与者强调了安心的重要性以及恢复的预期时间线。恢复意味着恢复功能和独立性，并回归有意义的活动，到六个月时大多数参与者也未完全实现这一点。
本研究首次探讨了肩部骨折恢复过程中的信息需求和经历。恢复对个体患者意味着什么，以及认识到脆弱感对恢复的影响程度是需要考虑的重要因素。临床医生应意识到这些损伤的全面影响，以指导患者的恢复过程，包括识别脆弱感和恢复其身份认同。采用以患者为中心的护理方法，并考虑患者在整个恢复过程中不断变化的优先事项和信息需求，可能会改善患者护理。
