Understanding Perceptions of Health Following Hip Fracture: Using a Phenomenological Framework to Explore the Opinions of Patients, Caregivers, and Providers
Year: 2015
Type: dissertation
Abstract: The following study was guided by an overall research question: "What does it mean to have a hip fracture?". Using a phenomenological approach, I interviewed individuals who experienced a hip fracture, primary caregivers, and healthcare providers (HCPs) with the following objectives in mind: (1) to clarify meanings and conceptualization of prognosis for patients and caregivers following hip fracture as compared to HCPs treating them, (2) to enhance our understanding how these perceptions impact healthcare delivery at both ends of the spectrum, and (3) to provide a rationale for these perspectives. 25 participants participated in in-depth interviews that were audio-taped. The transcripts were coded separately for patients and for HCPs. This work was conducted without a-priori-hypotheses and through an inductive thematic analysis. Prognosis was the underlying phenomenon with four sub-themes identified for patients and caregivers: forecast, non-knowledge, sense of self-ownership, and enlargement. Four other sub-themes were identified for HCPs: interconnectedness, hip work, embodiment, and forecast. HCPs have the right to assign prognosis; however, patients' perceptions can be affected, not only through words, but also through the actions exerted by those in the healthcare profession. Viewing prognosis as a perspective (a Heideggerian concept) rather than a foreshadowing formed the main theoretical underpinning. Other theories informed this work: embodiment (Merleau-Ponty, 1962), body-self dialectic (Gadow, 1980), and body work and power (Twigg, 2011). Implications for HCPs consist in aiding the patient to develop insight on his or her symptoms and situation in addition to developing a therapeutic relationship that can effect clinical change. Implications for patients/caregivers emphasize using the patient's agency to enhance his or her quality of life. Future research in the area of prognosis will consider social context, while exploring variability, perceived value, and the impact on outcomes following discussion on hip fracture interventions between HCPs and patients/caregivers.
Source: TSpace (University of Toronto)
Author: Amy Hoang‐Kim
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2528580031