Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients.
Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients.
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DOI：
10.1136/bmjopen-2014-005406
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发表时间：
2015-01-06
期刊：
影响因子：
2.9
通讯作者：
Costa M
中科院分区：
文献类型：
--
作者：
Griffiths F;Mason V;Boardman F;Dennick K;Haywood K;Achten J;Parsons N;Griffin X;Costa M
探讨患者在评估髋部骨折恢复情况时认为哪些是重要的，并考虑如何将这些优先事项用于评估髋部骨折服务的质量。半结构化访谈探讨髋部骨折术后4周和4个月两个时间点的康复经验。两种分析方法：对与髋部骨折康复相关的数据进行专题分析；总结参与者的整体经验。招募了31名参与者，其中20名是女性，12名有认知障碍。平均年龄81.5岁。对19名患者、14名护理人员和8名患者/护理人员进行了访谈；10名参与者接受了两次采访。英国西米德兰兹郡的一个主要创伤中心。对于有一定骨折前活动能力的参与者来说，稳定的活动能力（没有跌倒或害怕跌倒）对于有价值的活动是最重要的，并且能够在恢复过程中阐明他们的价值。机动性对于管理个人护理、购物和园艺等日常活动以及维持心理健康都很重要。一些参与者使用辅助移动设备或适应他们的限制。另一些人则通过增加护理来维持他们以前有限的功能。许多参与者无法清楚地说出他们认为髋部骨折是随着年龄增长而衰退的一部分。骨折和其他健康状况引起的问题是一个健康经历不可分割的一部分。骨折前的活动能力，对骨折前后活动能力下降的适应，以及患者是否认为自己随着年龄的增长而下降，都会影响患者在髋部骨折恢复过程中认为重要的事情。没有单一的患者报告的结果测量可以评估髋部骨折后所有患者的护理质量。一般与健康相关的生活质量工具可能在临床试验中提供有用的信息。
To explore what patients consider important when evaluating their recovery from hip fracture and to consider how these priorities could be used in the evaluation of the quality of hip fracture services. Semistructured interviews exploring the experience of recovery from hip fracture at two time points—4 weeks and 4 months postoperative hip fixation. Two approaches to analysis: thematic analysis of data specifically related to recovery from hip fracture; summarising the participant's experience overall. 31 participants were recruited, of whom 20 were women and 12 were cognitively impaired. Mean age was 81.5 years. Interviews were provided by 19 patients, 14 carers and 8 patient/carer dyad; 10 participants were interviewed twice. Single major trauma centre in the West Midlands of the UK. Stable mobility (without falls or fear of falls) for valued activities was considered most important by participants who had some prefracture mobility and were able to articulate what they valued during recovery. Mobility was important for managing personal care, for day-to-day activities such as shopping and gardening, and for maintenance of mental well-being. Some participants used assistive mobility devices or adapted to their limitations. Others maintained their previous limited function through increased care provision. Many participants were unable to articulate what they valued as hip fracture was perceived as part of their decline with age. The fracture and problems from other health conditions were an inseparable part of one health experience. Prefracture mobility, adaptations to reduced mobility before or after fracture, and whether or not patients perceive themselves to be declining with age influence what patients consider important during recovery from hip fracture. No single patient-reported outcome measure could evaluate quality of care for all patients following hip fracture. General health-related quality of life tools may provide useful information within clinical trials.
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