Older adults’ perceptions of early rehabilitation and recovery after hip fracture surgery: a UK qualitative study

Abstract

Implications for rehabilitation-Hip fracture was perceived as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions.-Participants expressed uncertainty over their ability to recover their previous identity in the absence of professional support and/or social capital.-Healthcare professionals need to educate and empower older adults to take charge of their own recovery.-For successful implementation of the UK standards for acute physiotherapy, there is a need to contextualize goal setting to empower patients to define a fresh narrative of self.

Patient perspectives of recovery after hip fracture: a systematic review and qualitative synthesis

“…Four studies were conducted in the United Kingdom [10,12,29,30], three in Sweden [13,31,32], four in Canada [11,[33][34][35], one in Norway [36], in New Zealand [37], and one in the Netherlands [38]. Two studies were carried out in the hospital setting [10,13], one a rural community setting [31], and the remaining studies in urban community settings [11,12,29,30,[32][33][34][35][36][37][38]. Six studies selected their sample from participants of a randomized control trial [11,13,32,33,36,38].…”

“…Six studies selected their sample from participants of a randomized control trial [11,13,32,33,36,38]. Studies conducted included qualitative semi-structured interviews face to face [10,12,13,29,31,32,[36][37][38], via telephone [11,33,35], or face-to-face and/or by telephone [30,34]. Where reported, the mean interview duration ranged from 5-min [33] to 90-min [34,37].…”

“…Included studies made sense of their qualitative data by looking for patterns and coding using both inductive and deductive approaches. Five studies used thematic analysis [10][11][12]30,33,35], one used thematic and cross case analysis [12], four used a phenomenological approach [12,13,29,36], two used qualitative content analysis [13,31], two used a constant comparison analysis (as part of grounded theory approach) [37,38], one used topic coding [34], one used a phenomenographic method [32], and one a systematic text condensation [36].…”

“…In 2011, a literature review of older adults' recovery from hip fracture suggested patient recovery outcome is influenced by physical function and psychosocial factors [9]. Since this time, there has been an influx of qualitative evidence exploring both patient and carer's perspectives of recovery at different stages after hip fracture [10][11][12][13]. This evidence adds depth to previous understanding of quantitative trajectories for recovery [11,12] as well as patient and carer's perspectives of care received in support of recovery after hip fracture [10,13].…”

“…Since this time, there has been an influx of qualitative evidence exploring both patient and carer's perspectives of recovery at different stages after hip fracture [10][11][12][13]. This evidence adds depth to previous understanding of quantitative trajectories for recovery [11,12] as well as patient and carer's perspectives of care received in support of recovery after hip fracture [10,13]. This evidence has been recognized through the publication of reviews synthesizing the evidence related to care about hip fracture from the informal carer's perspective [14] and the patient's perspective of community-based rehabilitation [15].…”