659 Patient Perspectives of Recovery After Hip Fracture: A Systematic Review and Qualitative Synthesis

Abstract

Background Recovery is multidimensional highlighted by a wealth of qualitative evidence published on patient perspectives of recovery after hip fracture. The purpose of the current review is to synthesize this evidence of patients’ perspectives of recovery after hip fracture across the care continuum. Methods A systematic search was conducted, focusing on qualitative data from hip fracture patients. Two authors independently screened title and abstracts, full texts, completed extraction, and quality appraisal. Themes for this review were generated using a thematic synthesis of data from original studies. Results Fourteen qualitative studies were included in this review. The overall quality of included studies was high. We identified four review themes: defining recovery, feelings of vulnerability, driving recovery, and reliance on support. Patients considered recovery as a return to prefracture activities or ‘normal’ enabling independence. Feelings of vulnerability were observed for patients irrespective of the time since hip fracture and only diminished when recovery of function and activities enabled participation in valued activities e.g. outdoor mobility. Participants expressed a desire to actively engage in recovery with realistic expectations and benefits of meaningful feedback reported. Reliance on healthcare support varied by time since fracture with patients highlighting a greater reliance on professional support in the early versus late stages of recovery. Reliance on social support persisted until recovery was perceived to have been achieved and was highlighted more for participants who were living alone. Conclusion Patient perspectives of recovery enhance previous understanding of recovery domains. Patient perspectives highlighted hip fracture as a major life event which requires health professional and social support to overcome feelings of vulnerability and enable active engagement in recovery. Future research should investigate the recovery perspective of patients with cognitive impairment, and further consider perspectives on recovery from carers.