Patients' perceptions of rehabilitation in the community following hip fracture surgery. A qualitative thematic synthesis

Abstract

Background: Hip fracture is one of the most common injuries in adults and can be a life changing experience for most. Many patients are ill-prepared for the changes in their normal daily activity that often occur in the following months after surgery. Community rehabilitation services vary, as management often focuses on acute over community services. This can impact on the patient's experience post hip fracture.

Objectives: The aim of this review was to understand and examine patients' perspective, views and experiences of physiotherapy rehabilitation in the community after hip fracture surgery, to improve future clinical practice for this population.

Design: A qualitative thematic synthesis was undertaken to investigate the aim. A content thematic analysis approach was used to analyse the qualitative data.

Data sources: A systematic search was carried out of the following databases: CINAHL, PEDro, PubMed, Whiley Online, AMED & CINAHL. Further searches were performed in Google Scholar and backwards citation was used to search within included studies.

Study selection: A review of qualitative studies was performed using the SPIDER tool for identification of suitable studies and the CASP tool for analysis of quality. Studies were included if they were qualitative or part qualitative and involved patients' perceptions of rehabilitation after hip fracture following hospital discharge.

Results: Full text review was performed on 35 studies of which, 10 were identified as suitable. Three key themes were identified regarding experiences of rehabilitation within the community after hip fracture: Engaging in physical activity; Maintaining a positive perspective, and Support.

Conclusion: Findings support the need for the patient perspective and experience to be considered in the improvement of hip fracture care pathways regarding rehabilitation in the community setting after hip fracture. This can help identify key areas of improvement in rehabilitation to enhance and improve the patient journey after hip fracture. Systematic Review Registration Number PROSPERO CRD42018095434.

Keywords: Hip fracture; Patient perception; Rehabilitation.