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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:

期数:

2025年01期

页码:

29-38

栏目:

康复医学

出版日期:

2025-03-05

文章信息/Info

Title:

Middle-aged and elderly patients’ perceptions of rehabilitation treatment and functional recovery after distal radius fragility fractures: A qualitative study

作者:

聂悦悦; 王浩; 张嘉望; 刘楠; 崔国庆

100191 北京大学第三医院康复医学科

Author(s):

Nie Yueyue;  Wanghao;  Zhang Jiawang;  Liunan;  Cui Guoqing.

Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing 100191, China

关键词:

桡骨远端骨折;  质性研究;  康复;  参与度;  肩关节病变

Keywords:

Distal radius fracture;  Qualitative research;  Rehabilitation;  Participation;  Shoulder joint disorders

DOI:

DOI：10.3877/cma.j.issn.2096-0263.2025.01.005

文献标志码:

A

摘要:

目的 通过半结构化访谈法探索患者对桡骨远端脆性骨折后康复治疗及功能恢复的认识；为制定桡骨远端脆性骨折保守治疗及术后早期康复治疗的最佳实践方案提供新思路。方法 收集2022年10月至2023年1月就诊于北京大学第三医院康复医学科及骨科，诊断为桡骨远端脆性骨折的病例样本23例。研究采用半结构化访谈法，查阅文献并制定访谈提纲，在样本病例间开展一对一访谈，收集访谈录音与文本数据，利用MAXQDA 2022软件对访谈资料进行语音转录与质性分析，研究患者对骨折后康复治疗及功能恢复的认识与期望。结果 本研究共纳入受试者23例，其中男性2例（53～56岁），女性21例（49～78岁）。使用三级编码方法分析访谈资料，提炼出50个初级范畴，归纳为14个主范畴，并最终确定了五个核心主题：1.中老年人跌倒风险评估与预防的重要性；2.康复治疗早期介入与全程指导的重要性；3.患者与家属积极参与康复治疗的重要性；4.有必要予以DRF中老年患者心理支持治疗；5.有必要定期评估患侧肩关节功能状态。结论 中老年桡骨远端脆性骨折患者认为早期康复介入与全程指导对于功能恢复和生活质量改善有重要影响。本研究建议在中老年桡骨远端脆性骨折康复治疗中需要综合考虑疼痛、腕关节功能、心理因素、参与度及肩关节功能等多方面因素，并进行跌倒风险评估与危险分层，采用多维度、个性化的康复策略，以促进患者全面康复、早日回归正常生活。

Abstract:

Objective 1.To investigate patients’ perceptions of rehabilitation treatment and functional recovery following distal radius fragility fractures through semi-structured interviews. 2.To provide novel insights for establishing best practice guidelines for conservative treatment and early postoperative rehabilitation of distal radius fragility fractures. Methods A sample of 23 cases diagnosed with distal radius fragility fractures was collected from the Departments of Rehabilitation Medicine and Orthopedics at Peking University Third Hospital between October 2022 and January 2023. Using a semi-structured interview guide developed based on a review of relevant literature, semi-structured interviews were conducted with the sample. Audio and textual data were collected and subsequently transcribed and analyzed using MAXQDA2022 software for qualitative data analysis. The aim was to explore patients’ perceptions regarding rehabilitation treatment and functional recovery post-fracture. Results The study included a total of 23 participants, comprising 2 males (aged 53-56) and 21 females (aged 49-78). Through three levels of coding analysis, 50 initial categories, 14 main categories, and 5 themes were identified (1.The importance of fall risk assessment and prevention in middle-aged and elderly individuals;2.The significance of early intervention and continuous guidance in rehabilitation treatment;3.The importance of active participation by patients and their families in rehabilitation treatment;4.The necessity of providing psychological support therapy for middle-aged and elderly patients with DRF;5.The necessity of regularly assessing the functional status of the affected shoulder joint). Conclusions This study indicates that early rehabilitation intervention and continuous guidance are perceived by middle-aged and elderly patients with distal radius fragility fractures as significantly beneficial for functional recovery and quality of life improvement. It is recommended that rehabilitation treatment for these patients comprehensively consider multiple factors, including pain, wrist joint function, psychological aspects, patient engagement, and shoulder joint function. Additionally, fall risk assessment and stratification should be conducted, and a multidimensional, personalized rehabilitation strategy should be employed to promote comprehensive recovery and facilitate an early return to normal life.

备注/Memo

备注/Memo:

基金项目：科技部国家重点研发计划（2020YFC2008803）；国家自然科学基金面上项目（81871851）

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更新日期/Last Update: 2025-03-10