Patienters oplevelse af et perioperativ forløb med colles fraktur – at stå alene med stærke smerter

Resumé
Formål
At undersøge patienters oplevelse af et perioperativ forløb med colles fraktur.
Baggrund
Gennem de sidste årtier er “Perioperative Surgical Home Model” (PSMH) anvendt i USA, modellen er anvendt i dansk kontekst på elektive forløb i cirka 10 år, men tidligere ikke på ortopædkirurgiske forløb med traumer som colles fraktur.
Metode
Et kvalitativt studie med 50 timers observation på tre afdelinger og 22 interviews med patienter henholdsvis 1 og 3 uger efter operation. Data blev analyseret med en Ricoeur-inspireret fortolkningsmetode.
Resultater
Vi fandt fire temaer:

• Ulidelige smerter i det akutte forløb
• Mangelfuld information og vejledning
• At forberede sig på operation
• At være alene og observere sig selv.

English abstract

Patients’ experiences of a perioperative course with Colles’ fracture – left alone with severe pain

Aim
To explore patients’ experiences of a perioperative course with Colles’ fracture.
Background
Over the past decades, the Perioperative Surgical Home Model (PSHM) has been used in the United States. In a Danish context, the model has been applied to elective surgical pathways for approximately ten years, but not previously to orthopaedic trauma pathways such as Colles’ fracture.
Method
A qualitative study comprising 50 hours of observation across three departments and 22 patient interviews conducted 1 and 3 weeks after surgery. Data were analysed using a Ricoeur-inspired interpretive approach.
Results
We identified four themes:
1. Unbearable pain in the acute phase
2. Inadequate information and guidance
3. Preparing for surgery
4. Being alone and observing oneself
Conclusion
The study showed that pain management and patient information are insufficient. There is a need for an individualised and holistic approach to the care pathway for patients with Colles’ fracture.
Clinical relevance
The findings may form the basis for changes in perioperative care pathways, in which large parts of rehabilitation take place at home, with the aim that patients do not feel left to manage on their own.

Keywords: Colles’ fracture, patient pathway, observation, interview, pain, information, nursing.