Don't Worry, Be Positive: Improving Functional Recovery 1 Year After Hip Fracture

Abstract

It is not uncommon for studies examining factors associated with functional recovery 1 year after hip fracture to be presented from the perspective of clinicians or researchers. Few studies have examined factors that facilitate functional recovery from the patient's perspective. This article discusses community‐dwelling older adults age 65 and older who sustained a hip fracture and received surgical repair and postacute rehabilitation. Data were collected 1 year after postacute rehabilitation. Content analysis was used for the descriptive study. Participants reported that rehabilitation services greatly facilitated their recovery. Participants also recognized the importance of their own motivation, and noted it was essential to maintain a positive attitude and fully engage in recommended rehabilitation activities. The keys to functional recovery were active participation in rehabilitation and following instructions from care providers. In addition, self‐determination, a positive attitude, and social support played significant roles in making rehabilitation work.

Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

“…207 The factors that are amenable to correction 144,208,209 and those that are not should be recognised at the start of any rehabilitation programme so that proper resources can be identified and expectations adjusted when chances of improvement are minimal. 179 Health professionals could then implement interventions to effectively motivate individuals who may not have been self-directed or determined to exercise, 72 especially when patients develop a sense of losing control 86 and become passive receivers of a service rather than actively seeking help.…”

“…Setting rehabilitation goals early on, such as returning home, regaining or maintaining pre-fracture function and independence or ambulation without assistance, facilitated the recovery process, as did intermediate goals such as the number of minutes exercised per day: 207 The trainer told me that if I stop exercising I would be back to where I started in two weeks. I thought, I have gotten to this point I can't quit.…”

“…Female patient 207 Some patients had difficulty engaging with complex collaborative decision-making because of unfavourable professional customs and configurations of local services; increased vulnerability arising from distress, anxiety and fear; existing or future comorbid medical conditions; a rapid decline in physical ability or mental capacity; or the loss or unavailability of close family or friends. These issues could coexist with poor coping strategies, such as distancing and avoiding seeking help from support networks.…”

“…Patients fracturing their hip usually had unmet information/education needs regarding their injury, the recovery process, 207 sources of help and support, the number and extent of exercises to carry out at…”

“…NIHR Journals Library www.journalslibrary.nihr.ac.uk Patients gained confidence from repeated, supervised practice of prolonged exercise sessions, 72,207 recognition of the resulting positive outcomes, verbal encouragement from the supervising professionals 72 and modelling exercises, 226 in which the professionals performed the exercise with the participants, all of which increased their self-efficacy and willingness to engage in the exercise programme.…”