Older adults' perspectives on rehabilitation and recovery one year after a hip fracture – a qualitative study

Karlsson, Anneli; Stenvall, Michael; Lindelöf, Nina

doi:10.1186/s12877-022-03119-y

Cited by 7 publications

(5 citation statements)

References 62 publications

(63 reference statements)

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“…Nevertheless, the present results support the results of previous studies from different countries. [4][5][6]9,52,54,55,[67][68][69][70][71][72][73] An international survey would improve the external validity of our findings. Another potential limitation is that the opinions of patients with stroke and patients with fracture might have been overstated in the current sample.…”

Section: Limitationsmentioning

confidence: 77%

Patients’ and Clinicians’ Perceptions of Motivational Factors in Rehabilitation

Oyake

Yamauchi

Inoue

et al. 2022

Preprint

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Importance: Patient motivation is an important determinant of rehabilitation outcomes. Differences in patients' and clinicians' perceptions of motivational factors can potentially hinder patient-centered care. Objective: To compare patients' and clinicians' perceptions of the most important factors in motivating patients for rehabilitation. Design: This multicenter descriptive cross-sectional survey was conducted from January to March 2022. Setting: Thirteen hospitals with a convalescent rehabilitation ward. Participants: Patients with neurological or orthopedic disorders undergoing inpatient rehabilitation and clinicians, including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists, were selected purposively based on the inclusion criteria. Main Outcomes and Measures: Patients and clinicians were asked to choose the most important factor from a list of potential motivational factors. The main outcome was patients' and clinicians' perceptions of the relative importance of various motivational factors for rehabilitation. Results: We obtained data from 479 patients and 401 clinicians. Response rates in the patient and clinician surveys were 92.1% and 62.2%, respectively. The most common primary reasons for patients' hospitalizations were stroke (45.5%) and fracture (42.2%). Approximately half of the clinicians were physical therapists (49.9%). "Realization of recovery," "goal setting," and "practice related to the patient's experience and lifestyle" were the three factors most frequently selected as most important by both patients and clinicians, chosen by 10.4%-26.5% of patients and 9.5%-36.7% of clinicians. Only five were rated as most important by 5% of clinicians; however, nine factors were selected by 5% of patients. Of these nine motivational factors, "medical information" (odds ratio: 5.19; 95% confidence interval: 2.24-11.60) and "control of task difficulty" (odds ratio: 2.70; 95% confidence interval: 1.32-5.80) were selected by a significantly higher proportion of patients than clinicians. Conclusions and Relevance: The three most frequently endorsed motivational factors were identical for patients and clinicians. The preferences of patients were more diverse than those of clinicians, and some motivational factors were preferred by patients over clinicians. Therefore, when determining motivational strategies, rehabilitation clinicians should consider individual patient preferences in addition to utilizing the core motivational factors supported by both parties.

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Section: Limitationsmentioning

confidence: 77%

Patients’ and Clinicians’ Perceptions of Motivational Factors in Rehabilitation

Oyake

Yamauchi

Inoue

et al. 2022

Preprint

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“…Postoperative social support from family and friends is crucial for satisfactory recovery after many orthopedic procedures. 41 Recovery after treatment is thus facilitated by both physical and psychosocial factors, which may contribute to the accelerated recovery in active older patients. Finally, a previous study 17 on DRFs found that hypertension is highly associated with complication rates after surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Other factors for earlier recovery may be related to psychosocial factors, such as motivation and rehabilitation efforts to return to preinjury activity levels. Postoperative social support from family and friends is crucial for satisfactory recovery after many orthopedic procedures . Recovery after treatment is thus facilitated by both physical and psychosocial factors, which may contribute to the accelerated recovery in active older patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Distal Radius Fracture Outcomes in Older Adults Stratified by Chronologic vs Physiologic Age Managed With Casting vs Surgery

Jayaram

Yoon

et al. 2023

JAMA Netw Open

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ImportanceCasting is recommended for adults older than 65 years with distal radius fractures (DRFs) because similar long-term outcomes are achieved regardless of treatment. However, physiologically younger adults could benefit from operative DRF management despite advanced chronologic age.ObjectiveTo examine how chronologic age compares with measures of physiologic age in DRF treatment recovery.Design, Setting, and ParticipantsThis retrospective secondary analysis of the Wrist and Radius Injury Surgical Trial (WRIST) was performed from May 1 to August 31, 2022. WRIST was a 24-center randomized clinical trial that enrolled participants older than 60 years with unstable DRFs from April 1, 2012, to December 31, 2016.InterventionsParticipants selected casting or surgery. Patients who selected surgery were randomly assigned to volar lock plating, percutaneous pinning, or external fixation. Participants were stratified by chronologic age, number of comorbidities, and activity status.Main Outcomes and MeasuresThe primary outcome was Michigan Hand Outcomes Questionnaire (MHQ) score assessed at 6 weeks, 3 months, 6 months, and 1 year. Partial correlation (PC) analysis adjusted for confounding.ResultsThe final cohort consisted of 293 participants (mean [SD] age, 71.1 [8.89] years; 255 [87%] female; 247 [85%] White), with 109 receiving casting and 184 receiving surgery. Increased chronologic age was associated with increased MHQ scores in the surgery group at all time points but decreased MHQ scores in the casting group at 12 months (mean [SD] score, −0.46 [0.21]; P = .03). High activity was associated with improved MHQ scores in the surgical cohort at 6 weeks (mean [SD] score, 12.21 [5.18]; PC = 0.27; P = .02) and 12 months (mean [SD] score, 13.25 [5.77]; PC = 0.17; P = .02). Comorbidities were associated with decreased MHQ scores at all time points in the casting group. Clinically significant differences in MHQ scores were associated with low physical activity, 4 or more comorbidities, or increased age by 15 years.Conclusions and RelevanceIn this retrospective secondary analysis of WRIST, chronologic age was not associated with functional demand. These findings suggest that physicians should counsel active older adults with few comorbidities on earlier return to daily activities after surgery compared with casting.Trial RegistrationClinicalTrials.gov Identifier: NCT01589692

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“…La prevalencia de lesionados por AT tiene su pico a una edad joven entre los 20 y 30 años (16) , en nuestros resultados se pueden observar que por cada año que aumenta la edad existe mayor probabilidad de requerimiento de rehabilitación. Aunque no se haya encontrado información acerca de la necesidad de rehabilitación con la edad, esta cumple un rol importante cuando se habla de supervivencia y recuperación de lesiones en accidentes (17) . Los mayores de 60 años pueden tener hasta el doble de riesgo de fallecimiento por AT en comparación con la población menor de 60 años; dicha premisa también puede aplicarse al requerimiento de rehabilitación.…”

Section: Discussionunclassified

“…Aunque los jóvenes del sexo masculino son los principales causantes y víctimas, nuestros resultados mencionan que en las personas mayores de 60 años no existen diferencias entre el sexo de la víctima y el requerimiento de rehabilitación. Podrían existir diferencias a nivel hospitalario, incluyendo complicaciones y características específicas de las lesiones, como la osteoporosis y fractura de cadera en la mujer o las lesiones en extremidades y comorbilidades crónicas en el hombre (10,17) .…”

Section: Discussionunclassified

Factores asociados al requerimiento de rehabilitación física en los peatones sobrevivientes de atropello en Perú, 2016 - 2021

Roman-Lazarte,

Roman,

Chavez-Bustamante

2023

An Fac med

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Introducción. Los accidentes de tránsito (AT) son un problema de salud pública a nivel mundial, se estiman 1,3 millones de muertes anuales, y en los sobrevivientes deja secuelas traumáticas que pueden disminuir la calidad de vida. De las víctimas, los peatones lesionados representan el 22%. El objetivo del presente estudio fue determinar los factores asociados al requerimiento de rehabilitación física de los peatones lesionados por algún AT en el territorio peruano. Métodos. Se realizó un estudio observacional de corte transversal con los datos secundarios brindados por el Centro Nacional de Epidemiología, Prevención y Control de Enfermedades (CDC Perú) por medio de fichas epidemiológicas. Resultados. Se analizaron 14 186 registros que involucran a peatones lesionados por atropellamiento en carretera por algún vehículo motorizado entre el 2016 y el 2021. El 87,89% de las víctimas no requirieron rehabilitación posterior al suceso. Existe una mayor probabilidad de rehabilitación si el lesionado tiene una mayor edad y si la hora del accidente fue entre las 00:00 y 05:59 horas del día. Existe una menor probabilidad de rehabilitación si el accidente lo ocasiona un motocarro. Conclusiones. Existe una gran cantidad de accidentados jóvenes y adultos, sin embargo, la edad mayor se comporta como un factor asociado a la necesidad de rehabilitación, así mismo, el tipo de carretera y el tipo de vehículo causante influyen en el desenlace de la víctima.

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Older adults' perspectives on rehabilitation and recovery one year after a hip fracture – a qualitative study

Cited by 7 publications

References 62 publications

Patients’ and Clinicians’ Perceptions of Motivational Factors in Rehabilitation

Patients’ and Clinicians’ Perceptions of Motivational Factors in Rehabilitation

Comparison of Distal Radius Fracture Outcomes in Older Adults Stratified by Chronologic vs Physiologic Age Managed With Casting vs Surgery

Factores asociados al requerimiento de rehabilitación física en los peatones sobrevivientes de atropello en Perú, 2016 - 2021

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