Systems modelling as an approach for eliciting the mechanisms for hip fracture recovery among older adults in a participatory stakeholder engagement setting.

Autor:	Ansah JP; Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, United States.; Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore., Chia AW; Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore., Koh VJW; Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.; Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore., Lai WX; Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore., Koh JSB; Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore., Goh KS; Department of Geriatric Medicine, Changi General Hospital, Singapore, Singapore., Yeo W; Orthopaedic Diagnostics Centre, Singapore General Hospital, Singapore, Singapore., Howe TS; Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore., Seow DCC; Department of Geriatric Medicine, Singapore General Hospital, Singapore, Singapore., Mamun K; Department of Geriatric Medicine, Singapore General Hospital, Singapore, Singapore., Balasubramanian D; Department of Geriatric Medicine, Changi General Hospital, Singapore, Singapore., Varman SD; Department of Geriatric Medicine, Changi General Hospital, Singapore, Singapore., Yeo AKS; Department of Orthopaedic Surgery, Changi General Hospital, Singapore, Singapore., Elamin A; School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom., Chan AW; Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.; Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore., Matchar DB; Programme in Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
Jazyk:	angličtina
Zdroj:	Frontiers in rehabilitation sciences [Front Rehabil Sci] 2023 Jun 23; Vol. 4, pp. 1184484. Date of Electronic Publication: 2023 Jun 23 (Print Publication: 2023).
DOI:	10.3389/fresc.2023.1184484
Abstrakt:	Introduction: Due to an aging population, the rising prevalence and incidence of hip fractures and the associated health and economic burden present a challenge to healthcare systems worldwide. Studies have shown that a complex interplay of physiological, psychological, and social factors often affects the recovery trajectories of older adults with hip fractures, often complicating the recovery process. Methods: This research aims to actively engage stakeholders (including doctors, physiotherapists, hip fracture patients, and caregivers) using the systems modeling methodology of Group Model Building (GMB) to elicit the factors that promote or inhibit hip fracture recovery, incorporating a feedback perspective to inform system-wide interventions. Hip fracture stakeholder engagement was facilitated through the Group Model Building approach in a two-half-day workshop of 25 stakeholders. This approach combined different techniques to develop a comprehensive qualitative whole-system view model of the factors that promote or inhibit hip fracture recovery. Results: A conceptual, qualitative model of the dynamics of hip fracture recovery was developed that draws on stakeholders' personal experiences through a moderated interaction. Stakeholders identified four domains (i.e., expectation formation, rehabilitation, affordability/availability, and resilience building) that play a significant role in the hip fracture recovery journey.. Discussion: The insight that recovery of loss of function due to hip fracture is attributed to (a) the recognition of a gap between pre-fracture physical function and current physical function; and (b) the marshaling of psychological resilience to respond promptly to a physical functional loss via uptake of rehabilitation services is supported by findings and has several policy implications. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Ansah, Chia, Koh, Lai, Koh, Goh, Yeo, Howe, Seow, Mamun, Balasubramanian, Varman, Yeo, Elamin, Chan and Matchar.)
Databáze:	MEDLINE
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