Patient experience of long-term recovery after open fracture of the lower limb: a qualitative study using interviews in a community setting.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
09 10 2019
Historique:
entrez: 12 10 2019
pubmed: 12 10 2019
medline: 23 10 2020
Statut: epublish

Résumé

Treatment of open fractures is complex and patients may require muscle and skin grafts. The aim of this study was to gain a greater understanding of patient experience of recovery from open fracture of the lower limb 2-4 years postinjury. A phenomenological approach was used to guide the design of the study. Interviews took place between October 2016 and April 2017 in the participants' own homes or via telephone. England, UK. A purposive sample of 25 patients were interviewed with an age range of 26-80 years (median 51), 19 were male and six female, and time since injury was 24-49 months (median 35 months). The findings identified a focus on struggling to recover as participants created a new way of living, balancing moving forward with accepting how they are, while being uncertain of the future and experiencing cycles of progress and setbacks. This was expressed through three themes: (i) 'being disempowered' with the emotional impact of dependency and uncertainty, (ii) 'being changed' and living with being fragile and being unable to move freely and (iii) 'being myself' with a loss of self, feeling and looking different, alongside recreation of self in which they integrated the past, present and future to find meaningful ways of being themselves. This study identified the long-term disruption caused by serious injury, the hidden work of integration that is required in order to move forward and maximise potential for recovery. Supportive strategies that help people to self-manage their everyday emotional and physical experience of recovery from injury are required. Research should focus on developing and testing effective interventions that provide support and self-management within a holistic rehabilitation plan. Current Controlled Trials ISRCTN33756652; Post-results.

Identifiants

pubmed: 31601595
pii: bmjopen-2019-031261
doi: 10.1136/bmjopen-2019-031261
pmc: PMC6797425
doi:

Banques de données

ISRCTN
['ISRCTN33756652']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e031261

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Physiotherapy. 2017 Sep;103(3):322-329
pubmed: 26850515
Eur J Cancer Care (Engl). 2018 May;27(3):e12847
pubmed: 29630750
J Adv Nurs. 2009 Sep;65(9):1778-89
pubmed: 19694841
Am J Psychiatry. 2010 Mar;167(3):312-20
pubmed: 20048022
BMC Musculoskelet Disord. 2012 Nov 21;13:224
pubmed: 23171034
JAMA. 2018 Jun 12;319(22):2280-2288
pubmed: 29896626
Health Technol Assess. 2018 Dec;22(73):1-162
pubmed: 30573002
Health Technol Assess. 2016 Oct;20(75):1-158
pubmed: 27735787
J Bone Joint Surg Am. 2006 Sep;88(9):1927-33
pubmed: 16951107
J Bone Joint Surg Am. 1976 Jun;58(4):453-8
pubmed: 773941
Qual Health Res. 2003 Nov;13(9):1291-310
pubmed: 14606414
Body Image. 2004 Jan;1(1):83-97
pubmed: 18089143
Bone Joint J. 2018 Apr 1;100-B(4):522-526
pubmed: 29629594
Int J Nurs Stud. 2012 Jul;49(7):872-9
pubmed: 22342114
J Bone Joint Surg Am. 2003 Sep;85(9):1689-97
pubmed: 12954826
Injury. 2012 Jun;43(6):891-7
pubmed: 22204774
Injury. 2012 Jul;43(7):1071-8
pubmed: 22356720

Auteurs

Sophie Rees (S)

Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.

Elizabeth Tutton (E)

NDORMS, University of Oxford, Oxford, UK liz.tutton@ndorms.ox.ac.uk.

Juul Achten (J)

NDORMS, University of Oxford, Oxford, UK.

Julie Bruce (J)

Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.

Matthew L Costa (ML)

NDORMS, University of Oxford, Oxford, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH