Asplin G1,2, Fagevik Olsén M1,3, Zidén L1,2
1Sahlgrenska Academy at Gothenburg University, Institute of Neuroscience and Physiology, Gothenburg, Sweden, 2Sahlgrenska University Hospital, Physiotherapy, Molndal, Sweden, 3Sahlgrenska University Hospital, Physiotherapy, Gothenburg, Sweden
Background: Hip fracture is considered the most serious osteoporotic fracture in the elderly with approximately 50% regaining previous levels of autonomy and mobility. Implementation of multidisciplinary clinical pathways, have resulted in improvements including; decreased mortality, post-operative complications, length of stay as well as facilitating functional recovery. Furthermore, pathways promoting patient participation have shown to improve patient outcomes with increased motivation and likelihood of patients achieving their rehabilitation goals, and experiencing higher quality of care. However, patients have also described experiences conflicting with their own needs and wishes limiting participation, e.g. having to comply with healthcare routines, and excessive expectations placed on them by Health Care Professionals (HCPs).
To gain a better understanding of the concepts of practice of relevance to patients, we must first know how patients experience care and adapt processes accordingly. Studies have highlighted the need for HCPs to understand the psychological factors that can impact on the recovery process, to acknowledge differences in patients' willingness to participate in rehabilitation, the importance for HCPs to recognise patients' preferences, perceptions of their own capability to regain pre-fracture function, and what patients consider important to enhance their recovery.
Purpose: The aims of this study was to explore patients' experiences of their recovery after hip fracture surgery and the use of Traffic Light System-BasicADL as an instrument to assess function and promote patient participation in their rehabilitation process.
Methods: Twenty patients (14 females and 6 males), aged 66-94, were interviewed during the acute in-patient phase after hip-fracture surgery. A qualitative content analysis method was used for analysis of data.
Results: Patients with more complex needs expressed they required more attention and care adapted to fit their individual physical and psychological needs, which was particularly apparent during the initial post-operative period when dependent on HCPs to transfer. Patients also reported becoming increasingly worried, insecure and questioning their future during inpatient care.
Traffic Light System-BasicADL was described as a simple and useful tool highlighting level of function, increasing self-confidence and stimulating patients to continue to strive for independence, as well as a tool for discussing goals. However, some patients were not interested whilst others felt they had not been given the opportunity to be involved.
Two categories were identified: 'Being seen as a person' with subcategories; Interaction affects trust and security; Information is key to understanding; and Encouragement is essential to promote activity. And 'Striving for Independence', with subcategories; Accepting the situation whilst trying to remain positive; The greener the better, but it's up to me; Ask me, I have goals; and Uncertainties concerning future.
Conclusion(s): To improve services and provide better quality of care, it is essential to continue to acknowledge the patients experiences, needs and preferences and make efforts to accommodate these where possible.
Implications: HCPs must recognise that patients with hip fracture are individuals, with varying needs that change across the continuum of recovery.
Keywords: Hip fracture, patient experience, qualitative content analysis
Funding acknowledgements: Research and Development Fund, Gothenburg and South Bohuslan, Renée Eanders Fund and Hjalmar Svensson Fund
To gain a better understanding of the concepts of practice of relevance to patients, we must first know how patients experience care and adapt processes accordingly. Studies have highlighted the need for HCPs to understand the psychological factors that can impact on the recovery process, to acknowledge differences in patients' willingness to participate in rehabilitation, the importance for HCPs to recognise patients' preferences, perceptions of their own capability to regain pre-fracture function, and what patients consider important to enhance their recovery.
Purpose: The aims of this study was to explore patients' experiences of their recovery after hip fracture surgery and the use of Traffic Light System-BasicADL as an instrument to assess function and promote patient participation in their rehabilitation process.
Methods: Twenty patients (14 females and 6 males), aged 66-94, were interviewed during the acute in-patient phase after hip-fracture surgery. A qualitative content analysis method was used for analysis of data.
Results: Patients with more complex needs expressed they required more attention and care adapted to fit their individual physical and psychological needs, which was particularly apparent during the initial post-operative period when dependent on HCPs to transfer. Patients also reported becoming increasingly worried, insecure and questioning their future during inpatient care.
Traffic Light System-BasicADL was described as a simple and useful tool highlighting level of function, increasing self-confidence and stimulating patients to continue to strive for independence, as well as a tool for discussing goals. However, some patients were not interested whilst others felt they had not been given the opportunity to be involved.
Two categories were identified: 'Being seen as a person' with subcategories; Interaction affects trust and security; Information is key to understanding; and Encouragement is essential to promote activity. And 'Striving for Independence', with subcategories; Accepting the situation whilst trying to remain positive; The greener the better, but it's up to me; Ask me, I have goals; and Uncertainties concerning future.
Conclusion(s): To improve services and provide better quality of care, it is essential to continue to acknowledge the patients experiences, needs and preferences and make efforts to accommodate these where possible.
Implications: HCPs must recognise that patients with hip fracture are individuals, with varying needs that change across the continuum of recovery.
Keywords: Hip fracture, patient experience, qualitative content analysis
Funding acknowledgements: Research and Development Fund, Gothenburg and South Bohuslan, Renée Eanders Fund and Hjalmar Svensson Fund
Topic: Older people; Orthopaedics; Musculoskeletal: lower limb
Ethics approval required: Yes
Institution: University of Gothenburg, Sweden
Ethics committee: Regional Ethics Board in Gothenburg, Sweden,
Ethics number: Dnr 351-10
All authors, affiliations and abstracts have been published as submitted.
