Managing Psycho-Social-Cognitive Factors during Hip/knee Fracture Rehabilitation for Older Adults: Clinicians' Experiences

Abstract

To explore the healthcare providers' experiences in identifying and managing psychosocial and cognitive factors (PSC) during hip/knee fracture rehabilitation for older adults in Nigeria. An interpretive description approach, purposively recruited and conducted focus group discussions with three rehabilitation teams- two orthopedic surgeons, three physiotherapists, six nurses, two orthotics, two physiotherapy assistants was adopted for this study. Thirty older adults' case notes identified by the rehabilitation team were retrospectively reviewed. . Data were analyzed using content analysis. Three interconnected steps emerged across the continuum of care (admission, pre-during-post-surgery). HCPS stated that using health, medical and social cues to identify PSC factors should be the first approach, followed by subjective and objective assessment of the PSC factors. The HCPs suggested that it requires a collaborative effort to intervene PSC. Effective referral system and iterative communication between rehabilitation team members and older adults/relatives are the bedrock of efficient and effective collaboration and should be actively practiced during hip fracture management. HCPs are encourage to systematically use the three steps described in this study when identifying and managing PSC factors during hip/knee fracture rehabilitation for older adults.

Keywords:  Healthcare providers, Hip fracture, Interpretive description, knee fracture, Nigeria, Older adults