"I didn't know what I could do": Behaviors, knowledge and beliefs, and social facilitation after distal radius fracture.

Autor: Stern BZ; Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA; Kessler Rehabilitation Center, Howell, NJ, USA. Electronic address: brocha.stern@nyu.edu., Howe TH; Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA., Njelesani J; Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of hand therapy : official journal of the American Society of Hand Therapists [J Hand Ther] 2023 Jan-Mar; Vol. 36 (1), pp. 148-157. Date of Electronic Publication: 2021 Oct 28.
DOI: 10.1016/j.jht.2021.09.003
Abstrakt: 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.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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