Patients’ perceptions of repair, rehabilitation and recovery after major orthopaedic trauma: a qualitative study

Claydon, J.; Robinson, Lisa J.; Aldridge, Stephen

doi:10.1016/j.physio.2015.11.002

Cited by 28 publications

(63 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite such advancements, national audit data indicate that only 5% of NHS patients with traumatic injuries currently have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. Qualitative research from our team has previously described the patient experience following major trauma as a journey through repair and rehabilitation to achieve recovery . The conceptual framework presented in this article would appear to support this injury trajectory and illustrates the importance of a continuum of rehabilitation provision across the recovery pathway following major musculoskeletal trauma, from early rehabilitation in an acute inpatient setting to long‐term support in the community following hospital discharge.…”

Section: Discussionmentioning

confidence: 92%

Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation

Robinson

Stephens

Wilson

et al. 2019

Evaluation Clinical Practice

View full text Add to dashboard Cite

Rationale, Aims, and Objectives: The reorganization of acute major trauma pathways in England has increased survival following traumatic injury, resulting in an increased patient population with diverse and complex needs requiring specialist rehabilitation. However, national audit data indicate that only 5% of patients with traumatic injuries have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. This group concept mapping project aimed to identify the clinical service needs of individuals accessing our major trauma rehabilitation service, prioritize these needs, determine whether each of these needs is currently being met, and plan targeted service enhancements. Methods: Participants contributed towards a statement generation exercise to identify the key components of rehabilitation following major trauma, and individually sorted these statements into themes. Each statement was rated based on importance and current success. Multi-dimensional scaling and hierarchical cluster analysis were applied to the sorted data to produce themed clusters of ideas within concept maps. Priority values were applied to these maps to identify key areas for targeted service enhancement. Results: Fifty-eight patients and health care professionals participated in the ideas generation activity, 34 in the sorting, and 49 in the rating activity. A 7-item cluster map was agreed upon, containing the following named clusters: Communication and Coordination; Emotional and psychological wellbeing; Rehabilitation environment; Early rehabilitation; Structured therapy input; Planning for home; and Long-term support. Areas for targeted service enhancement included access to timely and adequate information provision, collaborative goal setting, and specialist pain management across the rehabilitation pathway. Conclusion: The conceptual framework presented in this article illustrates the importance of a continuum of rehabilitation provision across the injury trajectory, and provides a platform to track future service changes and facilitate the codesign of new rehabilitation interventions for individuals following major trauma.

show abstract

Section: Discussionmentioning

confidence: 92%

Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation

Robinson

Stephens

Wilson

et al. 2019

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Patients’ progression towards integration of physical change and self-identity was hindered by reminders of their injury, such as persistent pain, as their unreliable body23 was unable to achieve the intended activity. This process is noted in chronic illness24 and major trauma patients 3–6 months postinjury 25. Support that enables patients to feel a greater sense of empowerment and integrate bodily changes within their self-identity may be helpful.…”

Section: Discussionmentioning

confidence: 99%

Patient experience of long-term recovery after open fracture of the lower limb: a qualitative study using interviews in a community setting

et al. 2019

View full text Add to dashboard Cite

ObjectivesTreatment of open fractures is complex and patients may require muscle and skin grafts. The aim of this study was to gain a greater understanding of patient experience of recovery from open fracture of the lower limb 2–4 years postinjury.DesignA phenomenological approach was used to guide the design of the study. Interviews took place between October 2016 and April 2017 in the participants’ own homes or via telephone.SettingEngland, UK.ParticipantsA purposive sample of 25 patients were interviewed with an age range of 26–80 years (median 51), 19 were male and six female, and time since injury was 24–49 months (median 35 months).ResultsThe findings identified a focus on struggling to recover as participants created a new way of living, balancing moving forward with accepting how they are, while being uncertain of the future and experiencing cycles of progress and setbacks. This was expressed through three themes: (i) ‘being disempowered’ with the emotional impact of dependency and uncertainty, (ii) ‘being changed’ and living with being fragile and being unable to move freely and (iii) ‘being myself’ with a loss of self, feeling and looking different, alongside recreation of self in which they integrated the past, present and future to find meaningful ways of being themselves.ConclusionThis study identified the long-term disruption caused by serious injury, the hidden work of integration that is required in order to move forward and maximise potential for recovery. Supportive strategies that help people to self-manage their everyday emotional and physical experience of recovery from injury are required. Research should focus on developing and testing effective interventions that provide support and self-management within a holistic rehabilitation plan.Trial registration numberCurrent Controlled Trials ISRCTN33756652; Post-results.

show abstract

“…Although the musculoskeletal trauma population has heterogeneity e.g. type of injury, severity, location and structure injured, it is anticipated based on previous research that similar findings across different subgroups will be common with smaller differences depending on type and injury severity [13][14][15][16][17]. Therefore, the higher sample size in this study will allow for the heterogeneity of the musculoskeletal trauma population and ensuring the breadth of this population is represented, as well as taking into account potential drop outs, acknowledging that loss to follow up is common in this population [24].…”

Section: Patient Interviewsmentioning

confidence: 99%

“…Two studies have explored recovery following major musculoskeletal trauma [13,14], with one study interviewing patients at 3-6 months [13] and the other at 3, 4 and 5 years following injury [14]. Through semistructured interviews, both studies highlighted the complexity of establishing a definition of recovery, not least because perceptions of recovery change over time [13]. Findings also demonstrate how multiple factors such as pain, disability and return to work are impacted by anxiety and uncertainty following injury [14].…”

Section: Introductionmentioning

confidence: 99%

Successful recovery following musculoskeletal trauma: protocol for a qualitative study of patients’ and physiotherapists’ perceptions

Middlebrook

Heneghan

Falla

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Annually in the UK, 40,000–90,000 people are involved in a traumatic incident. Severity of injury and how well people recover from their injuries varies, with physiotherapy playing a key role in the rehabilitation process. Recovery is evaluated using multiple outcome measures for perceived levels of pain severity and quality of life. It is unclear however, what constitutes a successful recovery from injury throughout the course of recovery from the patient perspective, and whether this aligns with physiotherapists’ perspectives. Methods A qualitative study using two approaches: Interpretive Phenomenological Analysis (IPA) using semi-structured interviews and thematic analysis following the Kreuger framework for focus groups. A purposive sample of 20 patients who have experienced musculoskeletal trauma within the past 4 weeks and 12 physiotherapists who manage this patient population will be recruited from a single trauma centre in the UK. Semi-structured interviews with patients at 4 weeks, 6 and 12 months following injury, and 2 focus groups with physiotherapists will be undertaken at one time point. Views and perceptions on the definition of recovery and what constitutes a successful recovery will be explored using both methods, with a focus on the lived experience and patient journey following musculoskeletal trauma, and how this changes through the process of recovery. Data from both the semi-structured interviews and focus groups will be analysed separately and then integrated and synthesised into key themes ensuring similarities and differences are identified. Strategies to ensure trustworthiness e.g., reflexivity will be employed. Discussion Recovery following musculoskeletal trauma is complex and understanding of the concept of successful recovery and how this changes over time following an injury is largely unknown. It is imperative to understand the patient perspective and whether these perceptions align with current views of physiotherapists. A greater understanding of recovery following musculoskeletal trauma has potential to change clinical care, optimise patient centred care and improve efficiency and clinical decision making during rehabilitation. This in turn can contribute to improved clinical effectiveness, patient outcome and patient satisfaction with potential service and economic cost savings. This study has ethical approval (IRAS 287781/REC 20/PR/0712).

show abstract

Patients’ perceptions of repair, rehabilitation and recovery after major orthopaedic trauma: a qualitative study

Cited by 28 publications

References 21 publications

Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation

Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation

Patient experience of long-term recovery after open fracture of the lower limb: a qualitative study using interviews in a community setting

Successful recovery following musculoskeletal trauma: protocol for a qualitative study of patients’ and physiotherapists’ perceptions

Contact Info

Product

Resources

About