橈骨遠位端骨折に対する術後リハビリテーションにおける共同意思決定のための意思決定ニーズに関する質的考察：患者のエンパワーメント

Post-surgical rehabilitation may benefit patients after distal radius fractures, yet evidence guiding referral to supervised versus home-based rehabilitation remains unclear. Shared decision-making may facilitate a patient-centered decision about the most appropriate rehabilitation option. This study explores patients' decisional needs before shared decision-making regarding post-operative rehabilitation options following distal radius fracture surgery.

A qualitative study using focus group interviews informed by observations of consultations. Focus group interviews with patients (n = 17) and clinicians (n = 15) were analyzed deductively using the Ottawa Decision Support Framework, followed by an inductive analysis. Personal and clinical needs were linked to the International Classification of Functioning, Health, and Disability domains.

Observations indicated that decisions about the most appropriate rehabilitation option were mainly made by clinicians based on clinical assessments. In focus group interviews, a wish was expressed for decision-making to be shared, emphasizing that adequate patient information was a prerequisite. Decisional needs were related to decision timing, the possibility of expressing preferences, and rehabilitation options. Participants emphasized empowering patients in identifying their individual rehabilitation needs and becoming aware of their own preferences. Multiple factors were considered essential for making a patient-centered decision about the most appropriate rehabilitation option.

Both patients and clinicians were in favor of shared decision-making regarding rehabilitation options, but patients need information to empower their involvement in the decision-making process.