E Tutton1, J Achten2, S E Lamb3, K Willett2, M L Costa4. 1. University of Warwick, Warwick Medical School, Gibbet Hill Campus, Coventry CV4 7AL, UK and Oxford University Hospitals NHS Foundation Trust, Kadoorie Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK. 2. University of Oxford, Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, and Kadoorie Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK. 3. University of Oxford, Oxford Clinical Trials Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, and Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK. 4. University of Oxford, Oxford Trauma, Nuffield Department of Orthopaedics Rhenmatology and Musculoskeletal Sciences, and Kadoorie Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Abstract
Aims: The aim of this study was to explore the patients' experience of recovery from open fracture of the lower limb in acute care. Patients and Methods: A purposeful sample of 20 participants with a mean age of 40 years (20 to 82) (16 males, four females) were interviewed a mean of 12 days (five to 35) after their first surgical intervention took place between July 2012 and July 2013 in two National Health Service (NHS) trusts in England, United Kingdom. The qualitative interviews drew on phenomenology and analysis identified codes, which were drawn together into categories and themes. Results: The findings identify the vulnerability of the patients expressed through three themes; being emotionally fragile, being injured and living with injury. The participants felt a closeness to death and continued uncertainty regarding loss of their limb. They experienced strong emotions while also trying to contain their emotions for the benefit of others. Their sense of self changed as they became a person with visible wounds, needed intimate help, and endured pain. When ready, they imagined what it would be like to live with injury. Conclusion: Recovery activities require an increased focus on emotional wellbeing. Surgeons are aware of the need for clinical expertise and for adequate pain relief but may not be as aware that their patients require support regarding their body image and help to imagine their future life. Cite this article: Bone Joint J 2018;100-B:522-6.
Aims: The aim of this study was to explore the patients' experience of recovery from open fracture of the lower limb in acute care. Patients and Methods: A purposeful sample of 20 participants with a mean age of 40 years (20 to 82) (16 males, four females) were interviewed a mean of 12 days (five to 35) after their first surgical intervention took place between July 2012 and July 2013 in two National Health Service (NHS) trusts in England, United Kingdom. The qualitative interviews drew on phenomenology and analysis identified codes, which were drawn together into categories and themes. Results: The findings identify the vulnerability of the patients expressed through three themes; being emotionally fragile, being injured and living with injury. The participants felt a closeness to death and continued uncertainty regarding loss of their limb. They experienced strong emotions while also trying to contain their emotions for the benefit of others. Their sense of self changed as they became a person with visible wounds, needed intimate help, and endured pain. When ready, they imagined what it would be like to live with injury. Conclusion: Recovery activities require an increased focus on emotional wellbeing. Surgeons are aware of the need for clinical expertise and for adequate pain relief but may not be as aware that their patients require support regarding their body image and help to imagine their future life. Cite this article: Bone Joint J 2018;100-B:522-6.
Entities:
Keywords:
Acute care; Lower limb; Open fracture; Patient experience; Qualitative
Authors: Matthew L Costa; Juul Achten; Ruth Knight; May Ee Png; Julie Bruce; Susan Dutton; Jason Madan; Karan Vadher; Melina Dritsaki; James Masters; Louise Spoors; Marta Campolier; Nick Parsons; Miguel Fernandez; Suzanne Jones; Richard Grant; Jagdeep Nanchahal Journal: Health Technol Assess Date: 2020-08 Impact factor: 4.014
Authors: Jessica Nightingale; Kyle Lin Shu'an; Brigitte E Scammell; Paul Leighton; Ben J Ollivere Journal: Clin Orthop Relat Res Date: 2022-02-01 Impact factor: 4.755
Authors: H Leggett; A Scantlebury; A Byrne; M Harden; C Hewitt; G O'Carroll; H Sharma; C McDaid Journal: Health Qual Life Outcomes Date: 2021-05-31 Impact factor: 3.186
Authors: Kinga Papiez; Elizabeth Tutton; Emma E Phelps; Janis Baird; Matthew L Costa; Juul Achten; Phoebe Gibson; Daniel C Perry Journal: Bone Jt Open Date: 2021-06
Authors: David J Keene; Matthew L Costa; Elizabeth Tutton; Sally Hopewell; Vicki S Barber; Susan J Dutton; Anthony C Redmond; Keith Willett; Sarah E Lamb Journal: BMJ Open Date: 2019-11-02 Impact factor: 2.692