Brett, Jo (2014) Exploring the lived experience of having a hip fracture : identifying patients’ perspectives on their health care needs. PhD thesis, University of Warwick.

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Abstract

Hip fracture is one of the most common, serious injuries in old people in England, and with a growing older population it is increasingly important to understand the impact of hip fracture from the patient perspective in order to develop relevant and appropriate healthcare services. The aim of this study was to explore the lived experience of hip fracture in older people in England to inform service development.

A scoping review of the literature highlighted the lack of current evidence for hip fracture experience in England, with a particular dearth of evidence concerning the lived experience of hip fracture following discharge from hospital. However, the reviewed highlighted some international evidence around the lived experience of hip fracture while in hospital, and during initial rehabilitation. A meta-synthesis of the data was therefore conducted providing a more interpretive approach to analysing this data, and establishing a better understanding of the current literature on hip fracture patient experiences.

The gaps in the evidence reported in the current evidence base provided a rationale for a qualitative study. Hip fracture patients were interviewed at their place of residence 12 to 16 weeks after surgery. Interpretative phenomenological analysis methodology was used for 24 interviews, and patient and public involvement was integral to the study.

The study reported the impact on self, and the role of biographical disruption in triggering feelings of incompetency and frustration, particularly in those who had been relatively active prior to hip fracture. Participants perceived that others labelled them as ‘old’ and ‘disabled’ as they became less mobile and more dependent on those around them. Macro health care policies limited individualised care practices, and a greater emphasis is needed on discharge planning and continuity of care after discharge home. The study also reported the need for improved information provision and verbal communication throughout the care trajectory, and a key worker to co-ordinate their care to provide realistic expectations, reassurance and support throughout the recovery period is recommended. A model of continuity of care is presented to provide insight for the development of patient centred health care for this population.

Item Type:	Thesis (PhD)
Subjects:	R Medicine > RC Internal medicine R Medicine > RD Surgery
Library of Congress Subject Headings (LCSH):	Hip joint -- Fractures, Older people -- Medical care, Medical care -- Needs assessment
Official Date:	September 2014
Dates:	Date Event September 2014 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Staniszewaka, Sophie ; Haywood, Kirstie
Extent:	457 leaves
Language:	eng

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