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Understanding patient experience of distal tibia or ankle fracture : a qualitative systematic review
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Pearson, Nathan A., Tutton, Elizabeth, Gwilym, Stephen E., Joeris, Alexander, Grant, Richard, Keene, David J. and Haywood, Kirstie L. (2023) Understanding patient experience of distal tibia or ankle fracture : a qualitative systematic review. Bone & Joint Open, 4 (3). pp. 188-197. doi:10.1302/2633-1462.43.BJO-2022-0115.R1 ISSN 2633-1462.
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WRAP-Understanding-patient-experience-of-distal-tibia-or-ankle-fracture-a-qualitative-systematic-review-Haywood-2023.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (571Kb) | Preview |
Official URL: http://dx.doi.org/10.1302/2633-1462.43.BJO-2022-01...
Abstract
Aims
To systematically review qualitative studies of patients with distal tibia or ankle fracture, and explore their experience of injury and recovery.
Methods
We undertook a systematic review of qualitative studies. Five databases were searched from inception to 1 February 2022. All titles and abstracts were screened, and a subset were independently assessed. Methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. The GRADE-CERQual checklist was used to assign confidence ratings. Thematic synthesis was used to analyze data with the identification of codes which were drawn together to form subthemes and then themes.
Results
From 2,682 records, 15 studies were reviewed in full and four included in the review. A total of 72 patients were included across the four studies (47 female; mean age 50 years (17 to 80)). Methodological quality was high for all studies, and the GRADE-CERQual checklist provided confidence that the findings were an adequate representation of patient experience of distal tibia or ankle fracture. A central concept of ‘being the same but different’ conveyed the substantial disruption to patients’ self-identity caused by their injury. Patient experience of ‘being the same but different’ was expressed through three interrelated themes, with seven subthemes: i) being proactive where persistence, doing things differently and keeping busy prevailed; ii) living with change including symptoms, and living differently due to challenges at work and leisure; and iii) striving for normality, adapting while lacking in confidence, and feeling fearful and concerned about the future.
Conclusion
Ankle injuries were disruptive, draining, and impacted on patients’ wellbeing. Substantial short- and longer-term challenges were experienced during recovery. Rehabilitation and psychosocial treatment strategies may help to ameliorate these challenges. Patients may benefit from clinicians being cognisant of patient experience when assessing, treating, and discussing expectations and outcomes with patients.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RD Surgery | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing |
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Library of Congress Subject Headings (LCSH): | Ankle -- Fractures -- Treament, Ankle -- Wounds and injuries, Fibula -- Fractures, Tibia -- Fractures, Leg -- Fractures -- Treatment, Orthopedics | ||||||
Journal or Publication Title: | Bone & Joint Open | ||||||
Publisher: | British Editorial Society of Bone and Joint Surgery | ||||||
ISSN: | 2633-1462 | ||||||
Official Date: | 15 March 2023 | ||||||
Dates: |
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Volume: | 4 | ||||||
Number: | 3 | ||||||
Page Range: | pp. 188-197 | ||||||
DOI: | 10.1302/2633-1462.43.BJO-2022-0115.R1 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 20 March 2023 | ||||||
Date of first compliant Open Access: | 20 March 2023 | ||||||
RIOXX Funder/Project Grant: |
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