Narelle J Watson1,2, Sally A Martin2, Jennifer L Keating3. 1. 1 Faculty Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. 2. 2 Western Centre for Health Research & Education, Sunshine Hospital, St. Albans, VIC, Australia. 3. 3 Department of Physiotherapy, School of Primary and Allied Health Care, Faculty Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: To investigate patients' experience following wrist fracture, surgical repair and immobilization. DESIGN: A qualitative investigation involving individual participant interviews. SETTING: A metropolitan trauma service. SUBJECTS: In all, 31 participants were consecutively recruited from three groups within a randomized controlled trial comparing immobilization for one ( n = 11), three ( n = 10) or six weeks ( n = 10) following surgical treatment for wrist fracture. INTERVENTION: Individual interviews were conducted within three months of cast removal. Questions prompted discussion of the experience of fracture, surgery and immobilization. Interviews were audio-recorded, transcribed verbatim. At least two independent researchers performed coding and theming following principles of thematic analysis. RESULTS: Two themes were identified: (1) impact of the injury varies widely and (2) health care consumers want trustworthy dialogue. Participant reports indicated that recovery from wrist fracture, surgery and immobilization is challenging with significant changes to social role and increased dependence. For many, lack of empathy from health professionals and limited acknowledgement of the personal impact of injury led to dissatisfaction. Health professionals did not consistently tailor communication or adopt strategies to address specific needs for pain management, education and support requirements. There was no evidence that processes were implemented to enhance participant recall and comprehension. Most participants experienced their cast as a barrier to function. However, within the group of participants immobilized for one week, a number felt the cast was removed too soon. CONCLUSION: Participant reports indicate that recovery from surgically repaired wrist fracture is challenging. Opportunities exist to refine care in pain management, education and active engagement of patients in their care.
RCT Entities:
OBJECTIVE: To investigate patients' experience following wrist fracture, surgical repair and immobilization. DESIGN: A qualitative investigation involving individual participant interviews. SETTING: A metropolitan trauma service. SUBJECTS: In all, 31 participants were consecutively recruited from three groups within a randomized controlled trial comparing immobilization for one ( n = 11), three ( n = 10) or six weeks ( n = 10) following surgical treatment for wrist fracture. INTERVENTION: Individual interviews were conducted within three months of cast removal. Questions prompted discussion of the experience of fracture, surgery and immobilization. Interviews were audio-recorded, transcribed verbatim. At least two independent researchers performed coding and theming following principles of thematic analysis. RESULTS: Two themes were identified: (1) impact of the injury varies widely and (2) health care consumers want trustworthy dialogue. Participant reports indicated that recovery from wrist fracture, surgery and immobilization is challenging with significant changes to social role and increased dependence. For many, lack of empathy from health professionals and limited acknowledgement of the personal impact of injury led to dissatisfaction. Health professionals did not consistently tailor communication or adopt strategies to address specific needs for pain management, education and support requirements. There was no evidence that processes were implemented to enhance participantrecall and comprehension. Most participants experienced their cast as a barrier to function. However, within the group of participants immobilized for one week, a number felt the cast was removed too soon. CONCLUSION:Participant reports indicate that recovery from surgically repaired wrist fracture is challenging. Opportunities exist to refine care in pain management, education and active engagement of patients in their care.
Authors: Joseph Dias; Stephen Brealey; Liz Cook; Caroline Fairhurst; Sebastian Hinde; Paul Leighton; Surabhi Choudhary; Matthew Costa; Catherine Hewitt; Stephen Hodgson; Laura Jefferson; Kanagaratnam Jeyapalan; Ada Keding; Matthew Northgraves; Jared Palmer; Amar Rangan; Gerry Richardson; Nicholas Taub; Garry Tew; John Thompson; David Torgerson Journal: Health Technol Assess Date: 2020-10 Impact factor: 4.014
Authors: Joanna F Dipnall; Richard Page; Lan Du; Matthew Costa; Ronan A Lyons; Peter Cameron; Richard de Steiger; Raphael Hau; Andrew Bucknill; Andrew Oppy; Elton Edwards; Dinesh Varma; Myong Chol Jung; Belinda J Gabbe Journal: PLoS One Date: 2021-09-23 Impact factor: 3.240