Middlebrook Nicola, Heneghan Nicola R, Moffatt Maria, Silvester Lucy, Falla Deborah, Rushton Alison B, Soundy Andrew A
Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.
School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
PLoS One. 2025 May 28;20(5):e0323575. doi: 10.1371/journal.pone.0323575. eCollection 2025.
The aim of this qualitative phenomenology study using two methods (semi-structured interviews, focus groups), was to explore patients' and physiotherapists' views and perceptions of recovery, and what constitutes successful recovery following musculoskeletal trauma within the early stages of recovery. Participants were recruited from one major trauma centre in the United Kingdom and data collected via Microsoft Teams, or via a telephone call. Inclusion criteria for patient interviews: purposive sample of adults (≥18 years) who sustained a traumatic musculoskeletal injury, admitted as an inpatient within 4 weeks of injury, mental capacity, and able to communicate in English. Purposive sampling included age, gender, and injury characteristics. Focus group inclusion criteria: physiotherapists with experience managing patients with musculoskeletal trauma. Interviews and focus groups were informed by an evidenced based topic guide, audio recorded and transcribed verbatim. Trustworthiness of the data was strengthened using multiple strategies, e.g., member checking. Interpretative Phenomenological Analysis was used for the patient interviews and the Kreuger Framework for the focus groups. Participants included 17 patient interviews and 10 physiotherapists in two focus groups. Three themes emerged from patient interviews: understanding and impact of the accident and injuries, the early stages of recovery and physiotherapy, and healthcare and setting influences. Eight themes emerged from the focus groups: process of recovery, what is being fully recovered, it's more than just communicating with the patient, psychological impact of trauma affecting recovery, system influences/resources for recovery, influencers to recovery, barriers to using patient reported outcome measures to evaluate recovery, and what actually is useful to measure in trauma? Recovery following musculoskeletal trauma is complex, individual and focused on returning to 'normal'. Similarities across patient and physiotherapist views of recovery exist. Differences between participant groups were evident, centred on communication and what is important to the patient in their recovery.
这项定性现象学研究采用两种方法（半结构化访谈、焦点小组），旨在探讨患者和物理治疗师对康复的看法和认知，以及在康复早期阶段，肌肉骨骼创伤后成功康复的构成要素。参与者从英国的一个主要创伤中心招募，数据通过微软团队或电话收集。患者访谈的纳入标准：有创伤性肌肉骨骼损伤的成年人（≥18岁）的目的抽样，在受伤后4周内住院，有精神能力，且能用英语交流。目的抽样包括年龄、性别和损伤特征。焦点小组纳入标准：有管理肌肉骨骼创伤患者经验的物理治疗师。访谈和焦点小组由基于证据的主题指南提供信息，进行录音并逐字转录。使用多种策略（如成员核对）增强了数据的可信度。对患者访谈采用解释性现象学分析，对焦点小组采用克鲁格框架。参与者包括17次患者访谈和两个焦点小组中的10名物理治疗师。患者访谈中出现了三个主题：事故和损伤的理解及影响、康复和物理治疗的早期阶段、医疗保健和环境影响。焦点小组中出现了八个主题：康复过程、完全康复的定义、不仅仅是与患者沟通、创伤对康复的心理影响、康复的系统影响/资源、康复的影响因素、使用患者报告结局指标评估康复的障碍，以及在创伤中实际测量什么是有用的？肌肉骨骼创伤后的康复是复杂的、个体化的，且侧重于恢复到“正常”状态。患者和物理治疗师对康复的看法存在相似之处。参与者群体之间的差异很明显，集中在沟通以及康复中对患者重要的方面。
