Admitted with a hip fracture: patient perceptions of rehabilitation

The aim of this study was to describe the hip fracture patients' own perceptions of their situation and views of their responsibility in the rehabilitation process.

Although much research has been conducted on various aspects of the rehabilitation process in patients with a hip fracture, no attention has been given to the patients' own views of their situation at the start of this transitional process.

Thirteen informants with a hip fracture, aged 71-93 years, were interviewed postoperatively at a Swedish hospital. Phenomenographic analysis of the interview transcripts was performed.

The informants varied greatly in their engagement in the rehabilitation process, in their conceptions of who was responsible for their recovery and in their views on the need for information pertinent to their condition. Three categories of description were formulated: the Autonomous, i.e. patients who were self-sufficient and used to taking care of themselves and who searched for relevant information; the Modest, i.e. frail patients in need of more support who wanted information, but did not ask for it; and the Heedless, i.e. patients who were already dependent, who were not aware of their own responsibility and not interested in information. The informants also shared some traits: they all needed more information although not all were aware of it, they all worried about their future ability to walk again and they all had a strong zest for life.

Our results suggest that differences in patients' perspectives on the rehabilitation process need to be taken into account to enhance outcomes. Inadequate knowledge and engagement on the part of patients, with a hip fracture, probably have an impact on their rehabilitation outcome, but the degree of impact is uncertain.