The Library
Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups
Tools
Roberts, Jessica Louise, Din, Nafees Ud, Williams, Michelle, Hawkes, Claire, Charles, Joanna M., Hoare, Zoe, Morrison, Val, Alexander, Swapna, Lemmey, Andrew, Sackley, Catherine, Logan, Phillipa, Wilkinson, Clare, Rycroft-Malone, Jo and Williams, Nefyn H. (2017) Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups. BMJ Open, 7 (10). e014362. doi:10.1136/bmjopen-2016-014362 ISSN 2044-6055.
|
PDF
WRAP-development-evidence-based-complex-patients-hip-survey-Hawkes-2017.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (960Kb) | Preview |
Official URL: https://doi.org/10.1136/bmjopen-2016-014362
Abstract
Objectives
To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture.
Design
Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams.
Setting
North Wales. Participants Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13).
Results
The realist review provided understanding of how rehabilitation interventions work in the real-world context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring.
Conclusions
A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III).
Item Type: | Journal Article | ||||||
---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RD Surgery | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Pelvic bones -- Fractures -- Rehabilitation | ||||||
Journal or Publication Title: | BMJ Open | ||||||
Publisher: | BMJ | ||||||
ISSN: | 2044-6055 | ||||||
Official Date: | 11 October 2017 | ||||||
Dates: |
|
||||||
Volume: | 7 | ||||||
Number: | 10 | ||||||
Article Number: | e014362 | ||||||
DOI: | 10.1136/bmjopen-2016-014362 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 30 November 2018 | ||||||
Date of first compliant Open Access: | 30 November 2018 | ||||||
RIOXX Funder/Project Grant: |
|
||||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year