Griffiths, Frances, Mason, Victoria, Boardman, Felicity K., Dennick, Kathryn J., Haywood, Kirstie L., Achten, Juul, Parsons, Nicholas R., Griffin, Xavier L. and Costa, Matthew L. (2015) Evaluating recovery following hip fracture : a qualitative interview study of what is important to patients. British Medical Journal, Volume 5 (Number 1). pp. 1-10. doi:10.1136/bmjopen-2014-005406

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Abstract

Objective:
To explore what patients consider important when evaluating their recovery from hip fracture and to consider how these priorities could be used in the evaluation of the quality of hip fracture services.

Design:
Semistructured interviews exploring the experience of recovery from hip fracture at two time points—4 weeks and 4 months postoperative hip fixation. Two approaches to analysis: thematic analysis of data specifically related to recovery from hip fracture; summarising the participant's experience overall.

Participants:
31 participants were recruited, of whom 20 were women and 12 were cognitively impaired. Mean age was 81.5 years. Interviews were provided by 19 patients, 14 carers and 8 patient/carer dyad; 10 participants were interviewed twice.

Setting:
Single major trauma centre in the West Midlands of the UK.

Results:
Stable mobility (without falls or fear of falls) for valued activities was considered most important by participants who had some prefracture mobility and were able to articulate what they valued during recovery. Mobility was important for managing personal care, for day-to-day activities such as shopping and gardening, and for maintenance of mental well-being. Some participants used assistive mobility devices or adapted to their limitations. Others maintained their previous limited function through increased care provision. Many participants were unable to articulate what they valued as hip fracture was perceived as part of their decline with age. The fracture and problems from other health conditions were an inseparable part of one health experience.

Conclusions:
Prefracture mobility, adaptations to reduced mobility before or after fracture, and whether or not patients perceive themselves to be declining with age influence what patients consider important during recovery from hip fracture. No single patient-reported outcome measure could evaluate quality of care for all patients following hip fracture. General health-related quality of life tools may provide useful information within clinical trials.

Item Type:	Journal Article
Subjects:	R Medicine > RD Surgery
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Pelvic bones -- Fractures
Journal or Publication Title:	British Medical Journal
Publisher:	BMJ Group
ISSN:	0959-8146
Official Date:	6 January 2015
Dates:	Date Event 6 January 2015 Published 30 October 2014 Accepted 17 October 2014 Updated 4 April 2014 Submitted
Volume:	Volume 5
Number:	Number 1
Number of Pages:	10
Page Range:	pp. 1-10
DOI:	10.1136/bmjopen-2014-005406
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	National Institute for Health Research (Great Britain) (NIHR), University of Warwick, University Hospitals Coventry and Warwickshire NHS Trust
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