Highlights
- •Self-management can frame how patients handle recovery after distal radius fracture
- •Behaviors extended beyond adherence to addressing daily living and emotions
- •Limited knowledge, naivete, and uncertainty interacted with behaviors
- •Multiple forms and sources of social support were relevant for recovery
Abstract
Background
Biomedical models have limitations in explaining and predicting recovery after distal
radius fracture (DRF). Variation in recovery after DRF may be related to patients’
behaviors and beliefs, factors that can be framed using a lens of self-management.
We conceptualized the self-management process using social cognitive theory as reciprocal
interactions between behaviors, knowledge and beliefs, and social facilitation. Understanding
this process can contribute to needs identification to optimize recovery.
Purpose
Describe the components of the self-management process after DRF from the patient's
perspective.
Study design
Qualitative descriptive analysis.
Methods
Thirty-one adults aged 45-72 with a unilateral DRF were recruited from rehabilitation
centers and hand surgeons’ practices. They engaged in one semi-structured interview
2-4 weeks after discontinuation of full-time wrist immobilization. Data were analyzed
using qualitative descriptive techniques, including codes derived from the data and
conceptual framework. Codes and categories were organized using the three components
of the self-management process.
Results
Participants engaged in medical, role, and emotional management behaviors to address
multidimensional sequelae of injury, with various degrees of self-direction. They
described limited knowledge of their condition and its medical management, naive beliefs
about their expected recovery, and uncertainty regarding safe movement and use of
their extremity. They reported informational, instrumental, and emotional support
from health care professionals and a broader circle.
Conclusions
Descriptions of multiple domains of behaviors emphasized health-promoting actions
beyond adherence to medical recommendations. Engagement in behaviors was reciprocally
related to participants’ knowledge and beliefs, including illness and pain-related
perceptions. The findings highlight relevance of health behavior after DRF, which
can be facilitated by hand therapists as part of the social environment. Specifically,
hand therapists can assess and address patients’ behaviors and beliefs to support
optimal recovery.
Keywords
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JHT Read for Credit
Quiz: # 936
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.Components of the self-management process include
- a.social facilitation
- b.knowledge and beliefs
- c.behavior
- d.all of the above
- a.
- # 2.Data were gleaned from
- a.group discussions
- b.Zoom meetings
- c.semi-structured interviews
- d.pre-determined questions style interviews
- a.
- # 3.Typically patients reported
- a.poor understanding of their condition
- b.surprisingly good understanding of their situation
- c.little interest in their prognosis beyond pain concerns
- d.a childlike fascination with the medical-surgical management of their DRFx
- a.
- # 4.The study design is
- a.RCTs
- b.qualitative
- c.retrospective cohort
- d.case series
- a.
- # 5.The authors feel that therapists’ attitudes can have a significant impact on outcomes following DRFx
- a.possibly true
- b.absolutely true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: October 27, 2021
Accepted:
September 13,
2021
Received in revised form:
August 3,
2021
Received:
January 24,
2021
Footnotes
Conflict of interest: All named authors hereby declare that they have no conflicts of interest to disclose.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
