Bredy Terra M, Glasgow Celeste, Liddle Jacki, Patterson Freyr
Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD, Australia.
Department of Occupational Therapy, Ipswich Hospital, Ipswich, QLD, Australia.
Hand Ther. 2025 Jul 4:17589983251356913. doi: 10.1177/17589983251356913.
Distal radius fracture (DRF), a common upper extremity injury treated in outpatient hand therapy clinics, can lead to chronic pain and limitations in daily activities. Treatment often emphasises biomechanical aspects, like range of motion and oedema, while overlooking broader factors influencing recovery. This study explores therapists' perspectives on the recovery process in public healthcare and the contextual influences on therapeutic practices for patients with DRF.
Qualitative (Interpretive Description).
Hand therapists in Australia's public healthcare system were recruited through professional associations. Focus groups and follow-up interviews were conducted to explore the therapist's perspectives on patient recovery and the contextual factors influencing practice and outcomes. Reflexive thematic analysis was applied to analyse the data and develop themes.
37 participants contributed to eight focus groups and seven follow-up interviews. Two categories aligned with the research aims: (1) Perspectives on patient recovery and rehabilitation following DRF and (2) Perspectives on contextual and environmental influences shaping therapeutic approaches. Four main themes were generated: (1) recovery looks and feels different for everybody, (2) fundamental components of effective therapeutic approaches, (3) therapist experience makes a difference, and (4) it's the system: some things are out of our control.
Although therapists tended to prioritise a biomechanical approach for DRF, most acknowledged the importance of an individualised, biopsychosocial approach aligned with the International Classification of Functioning, Disability and Health framework. Experienced therapists shifted towards patient-centred care and recognised the significance of function in rehabilitation. However, contextual and systematic barriers within the Australian public healthcare system influence the therapeutic approach and recovery. Ongoing research is needed to refine practice and align therapist-patient expectations for DRF management.
桡骨远端骨折（DRF）是门诊手部治疗诊所常见的上肢损伤，可导致慢性疼痛和日常活动受限。治疗通常侧重于生物力学方面，如活动范围和水肿，而忽视了影响康复的更广泛因素。本研究探讨了治疗师对公共医疗保健中康复过程的看法以及对DRF患者治疗实践的背景影响。
定性研究（解释性描述）。
通过专业协会招募澳大利亚公共医疗系统中的手部治疗师。进行焦点小组讨论和后续访谈，以探讨治疗师对患者康复以及影响治疗实践和结果的背景因素的看法。应用反思性主题分析来分析数据并形成主题。
37名参与者参与了8个焦点小组讨论和7次后续访谈。与研究目标一致的有两类：（1）对DRF后患者康复和康复的看法，以及（2）对塑造治疗方法的背景和环境影响的看法。产生了四个主要主题：（1）每个人的康复看起来和感觉都不同，（2）有效治疗方法的基本组成部分，（3）治疗师的经验很重要，（4）是系统的问题：有些事情我们无法控制。
尽管治疗师倾向于优先采用生物力学方法治疗DRF，但大多数人承认与《国际功能、残疾和健康分类》框架一致的个体化生物心理社会方法的重要性。经验丰富的治疗师转向以患者为中心的护理，并认识到功能在康复中的重要性。然而，澳大利亚公共医疗系统中的背景和系统性障碍影响了治疗方法和康复。需要持续的研究来完善实践，并使治疗师和患者对DRF管理的期望保持一致。
