Patient Experience of Acute Rehabilitation After Hip Fracture

Each year, UK hospitals admit 75,000 older men and women with fracture of the hip. The injury has been dubbed the "hip attack", due to its clinical severity and adverse consequences. In fact, hip fracture is one of the most detrimental events in an older adult's life. Even with treatment, 30% of patients die within a year.Among survivors, 25% never walk again, and 22% transition from independent living to long-term care. Further, up to one third of patients develop new-onset depressive symptoms post fracture. Many fear admission to a nursing home, in fact a recent study noted that 80% would rather be dead.

Most hip fractures are treated surgically with the goals of reducing pain and re-establishing mobility. Allied health professionals develop rehabilitation interventions targeting the frequency, intensity, type and timing of rehabilitation to improve survival, recovery and quality of life after hip fracture surgery. Evaluation of these interventions rarely offer insight into the patient and caregiver experience. This insight is essential to determine feasibility, acceptability, and ultimately adherence to a new rehabilitation intervention.

As an example, clinicians and researchers suggest the timing of mobilisation will reduce complications and improve recovery after hip fracture surgery, particularly among older patients. The evidence to support these claims is inconsistent. Further, there is limited understanding of the patient experience of early mobilisation after hip fracture surgery. Indeed, for some patients the experience may be improved with a delay to first mobilisation.

To maximise adherence, it is important to also gauge patient's perceptions of perceived barriers to rehabilitation and recovery after hip fracture surgery. These barriers may present in the form of patient characteristics such as motivation. Alternatively, they may present in the form of injury characteristics such as perceived injury severity. Lastly, patient's may perceive healthcare barriers to rehabilitation such as perceived benefit.

DESIGN AND METHODS Design Qualitative study. Semi-structured interview The research assistant will first collect participant demographics - age, sex, previous functional status, previous place of residence - home or long-term care.