Patients Experiences and Preferences for Rehabilitation following an Ankle Fracture
Authors
Nielsen, Peter Kruse Aagaard ; Lollesgaard, Lærke Frost
Term
4. Semester
Publication year
2021
Submitted on
2021-06-01
Abstract
Formål: at udforske og forstå patienters oplevelser af fysioterapeutisk genoptræning efter en ankelfraktur og hvordan et sådant forløb kan tilrettelægges ud fra patienternes ønsker til form og indhold. Design og metode: Kvalitativt studie baseret på semistrukturerede interviews 9–26 uger efter, at deltagerne var startet i genoptræning. Deltagerne blev rekrutteret i Region Nordjylland via det regionale journalsystem. Interviewene fulgte en interviewguide, blev gennemført online, optaget og transskriberet ordret. To forskere analyserede materialet med refleksiv tematisk analyse, en metode til at identificere mønstre og temaer i udsagn. Resultater: Tretten personer deltog (ni kvinder), 46–69 år, median 60 år. Fire hovedtemaer (med fire deltemaer) fremkom: 1) Overgangen fra hospital til fysioterapeutisk genoptræning; 2) Struktur og indhold – herunder fælles beslutningstagning, tydelige mål og løbende progresionsopfølgning samt afslutning af forløbet; 3) Information, instruktion og kommunikation – herunder betydningen af skift af fysioterapeut; og 4) Undergrupper af patienter med forskellige behov. For et optimalt forløb fremhævede deltagerne tidlig opstart efter fjernelse af gips/støvle, tilstrækkelig information og klar kommunikation, individuelt tilrettelagt behandling og kontinuitet med den samme fysioterapeut. Konklusion: Deltagerne beskrev meget forskellige genoptræningsforløb. Når de blev bedt om at designe et optimalt forløb, nævnte de fælles temaer, men med stor variation inden for hvert tema. Resultaterne understreger behovet for patientcentreret fysioterapi og kan hjælpe klinikere med at målrette og forbedre genoptræning efter ankelfraktur.
Purpose: To explore patients’ experiences of physiotherapy after an ankle fracture and how rehabilitation could be organized to match their preferences for format and content. Design and methods: Qualitative study using semi-structured interviews conducted 9–26 weeks after participants started rehabilitation. Participants were identified in the North Denmark Region’s medical records system. Interviews followed a guide, were conducted online, recorded, and transcribed verbatim. Two researchers used reflexive thematic analysis, a method for identifying patterns and themes in what people say. Results: Thirteen participants were interviewed (nine women), ages 46–69 years (median 60). Four main themes (with four subthemes) emerged: 1) Transfer from hospital to physiotherapy; 2) Structure and content—including shared decision-making, clear goals with monitoring of progress, and when to end rehabilitation; 3) Information, instruction, and communication—including the impact of changing physiotherapists; and 4) Subgroups of patients with different needs. Factors viewed as important for optimal rehabilitation were starting early after removal of cast/boot, sufficient information and clear communication, individualized treatment, and continuity with the same physiotherapist. Conclusion: Participants experienced very different rehabilitation courses. When asked to design the optimal rehabilitation, they described common themes but with wide variation within each, highlighting the need for patient-centred physiotherapy. These findings can help clinicians better tailor rehabilitation after an ankle fracture.
[This summary has been rewritten with the help of AI based on the project's original abstract]
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