Thinking of the future and walking back to normal: an exploratory study of patients’ experiences during recovery from lower limb fracture

Abstract

Admission to hospital following a traumatic lower limb fracture is undoubtedly a stressful life event; however, few studies have detailed this from the patient's perspective. By exploring patients' experiences of hospitalization with lower limb trauma, this study aimed to explicate some of the factors impinging on the recovery trajectory. Patients' perceptions of the events influencing their strategies for coping with stress, hospitalization and temporary incapacity were investigated using a qualitative methodology. A convenience sample of nine patients was recruited from an orthopaedic ward in a district general hospital in Wales. The respondents used health diaries to document their recovery for up to 6 weeks after emergency surgery. These diaries were validated and supplemented by semi-structured interviews. Following their traumatic injuries, our respondents were subjected to a variety of stressors and uncertainties. They coped with this period of uncertainty by positive attempts to gain control over their situations, guided by an over-riding desire to 'return to normal' and assisted by the caring attributes of their nurses. From the experiences and events documented, this study was able to identify several stressors which could have been mitigated by optimization of the technical aspects of care, including the management of pain.

The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years

“…Participants expressed hope as a keenness to move forward and get back to normal in a similar way to other trauma patients; 88,90 however, the participants were hampered by fear, anxiety and weariness regarding weight-bearing. Loss of confidence, increased caution in general life and a fear of falling support existing evidence on patient experience in relation to trauma.…”

“…89 Patients interviewed up to 2 months after lower limb injury struggled with pain, fear and anxiety with a feeling of loss of control over their lives but had a strong desire to return to normal. 90 Trickett et al…”

Improving recovery—Learning from patients’ experiences after injury: A qualitative study

“…[6][7][8][9][10] There is comparatively little qualitative research with patients who have suffered an unintentional injury and almost none that considers the impact of a range of injury types (both minor and serious) in the context of the individual's age, gender, existing health status, socio-economic circumstances, household composition or other personal factors. 11,12 There has also been little research on patient perceptions and experiences of health and social care following injury and the extent to which this may influence recovery.…”

Process Diary as Methodological Approach in Longitudinal Phenomenological Research

“…A diary written each day for many months or years can furnish researchers with massive amounts of information. One problem presenting itself to researchers making use of diaries is that the large body of information yielded by diaries makes it difficult to find data of interest in the multitude of subjects, many of which are trivial, that are touched upon by a diary keeper (Griffiths & Jordan, 1998). Seibold (2000) conducted an interesting study based on the diary as an instrument of health research.…”

“…Writing a diary can highlight symptoms that should be brought to the attention of helping professionals. Diary writing may also develop the informant's skills of self-reflection (Griffiths & Jordan, 1998). Gibbs (1988) described a five step circular reflection process, which begins with a description of the event, then a description of the thoughts and feelings about the incident, and an evaluation of the event.…”