TY - JOUR
T1 - “I didn't know what I could do”
T2 - Behaviors, knowledge and beliefs, and social facilitation after distal radius fracture
AU - Stern, Brocha Z.
AU - Howe, Tsu Hsin
AU - Njelesani, Janet
N1 - Funding Information:
This article is based on research conducted by BZS in partial fulfillment of the requirements for the Doctor of Philosophy degree in Occupational Therapy at New York University, May 2020. We gratefully acknowledge the clinicians who assisted with recruitment and participants who shared their stories. This study was supported by the Burkhalter New Investigator Grant from the American Hand Therapy Foundation and an NYU Steinhardt Doctoral Research and Travel Grant. Support for BZS's time for manuscript development was provided by a grant from the National Institute on Disability , Independent Living , and Rehabilitation Research ( #90ARHF0003 , PI: Allen Heinemann). The content of this article is solely the responsibility of the authors and does not necessarily represent the views of the funding agencies.
Publisher Copyright:
© 2021
PY - 2023/1/1
Y1 - 2023/1/1
N2 - 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.
AB - 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.
KW - Belief
KW - Hand therapy
KW - Health behavior
KW - Qualitative
KW - Social environment
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U2 - 10.1016/j.jht.2021.09.003
DO - 10.1016/j.jht.2021.09.003
M3 - Article
C2 - 34756488
AN - SCOPUS:85118358195
SN - 0894-1130
VL - 36
SP - 148
EP - 157
JO - Journal of Hand Therapy
JF - Journal of Hand Therapy
IS - 1
ER -