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

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Rees, Sophie, Tutton, Elizabeth, Achten, Juul, Bruce, Julie and Costa, Matthew L. (2019) Patient experience of long term recovery after open fracture of the lower limb : a qualitative study using interviews in a community setting. BMJ Open, 9 . e031261. doi:10.1136/bmjopen-2019-031261 ISSN 2044-6055.

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Official URL: https://doi.org/10.1136/bmjopen-2019-031261

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Abstract

Objectives Treatment 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.

Design A 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.

Setting England, UK.

Participants A 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).

Results The 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.

Conclusion This 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.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
R Medicine > RD Surgery
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Wounds and injuries -- Treatment , Leg -- Wounds and injuries -- Treatment, Postoperative care, Patient satisfaction
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 9 October 2019
Dates:
DateEvent
9 October 2019Published
26 September 2019Accepted
Volume: 9
Article Number: e031261
DOI: 10.1136/bmjopen-2019-031261
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 2 October 2019
Date of first compliant Open Access: 3 October 2019
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Project number 10/57/20Health Technology Assessment programmehttp://dx.doi.org/10.13039/501100000664

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