Recovery from hip fracture: A longitudinal qualitative study of patients' experiences

Fox, Rebecca

Abstract

Abstract

Introduction: Evaluating recovery from hip fracture is important to ensure optimum care and the best outcomes for patients. Measuring outcomes is difficult due to heterogeneity in the hip fracture population and confounders such as ageing and co-morbidities. Current consensus recommends measuring mortality, pain, mobility, activities of daily living and quality of life using the EuroQol 5 Dimension score (EQ-5D) after hip fracture. However there is currently a lack of understanding of the longitudinal experience of recovery from hip fracture and the implications that this might have for outcome measurement.
Objectives: To explore patient experiences of recovery in the year following hip fracture.
Methods: Longitudinal qualitative semi-structured interviews were conducted with eleven extracapsular hip fracture patients (six men, age 69-92 years) in three phases over twelve months. Using thematic analysis methods, the data were coded and grouped into themes cross-sectionally within each phase and longitudinally across the phases.
Findings: The findings suggested there was a sequential experience in recovery. Early priorities focused on a theme of ‘physical and functional recovery’. Later, participants focused on recovering the ‘effect on lifestyle’ and ‘emotional response’ from the fracture. This supported participants to regain their sense of identity - adapting to and accepting the injury, in the context of their individual health and age - essential for a feeling of having recovered. Successful recovery was described as having achieved a satisfactory ‘new normal’.
Conclusions: This study highlighted a breadth of experience not currently included in consensus recommendations for health measurement, and that experiences continue to change across the 12 months. Findings from this study suggested that measuring outcomes with the EQ5D up to four months post injury may oversimplify the patient’s experience of, and priorities for, recovery following a hip fracture.

Keywords: hip fracture, experience, recovery, longitudinal, qualitative

• Thesis Type: Thesis
• Publicly Available Date: Jun 7, 2019
• Keywords: Hip fracture, qualitative, longitudinal, experience, recovery
• Public URL: https://uwe-repository.worktribe.com/output/883358
• Award Date: Aug 1, 2017