Establishing well-being after hip fracture: a systematic review and meta-synthesis

Abstract

Purpose: This study aimed to identify, appraise, aggregate and synthesize findings of experiences of self-confidence and well-being after hip fracture.

Method: The systematic review followed the Joanna Briggs Institute (JBI) guidelines. A three-step literature search strategy was followed. Included studies were critically appraised using the JBI critical appraisal tool. Data were analyzed into a meta-summary and a meta-synthesis using a hermeneutic approach.

Results: Twenty-nine studies were included in the analysis. The category “balancing a new life” was illustrated through older people’s “adaptations”, “adjustments” and “worries”. The second category “striving for interaction with new life possibilities” was built on experiences of “supportive interaction”, “missing interaction” and “obstacles”. The abstraction of the categories into the meta-synthesis “establishing well-being described the process of older people gradually coming to terms with new life conditions”. It was a process of building confidence through cooperation with staff.

Conclusions: Experiences of well-being were possible after hip fracture. Self-confidence enhanced adaptations and adjustments. Older people strived for an active everyday life where they had a sense of identity. Health professionals can facilitate the establishing of well-being through supportive interaction being aware of vulnerabilities and possibilities. This study provides information that may help in the development of interventions taking into account what is meaningful for older people.

Implications for Rehabilitation

• Both staff and significant others play a significant role during rehabilitation after hip fracture and can give rise to both well-being and suffering.

• During rehabilitation, experiences of self-efficacy can be important as they support progress and adaptation towards a new way of living.

• After hip fracture, older people may have worries and can experience a diversity of obstacles. A sensitivity towards these experiences by health care professionals can be a support for older people striving to establish well-being after hip fracture.

• To enhance functional ability and experiences of independency, it may be important to consider what it is about activities that are meaningful in the lives of older people after a hip fracture.

Keywords:

• Hip fracture
• meta-synthesis
• self-confidence
• systematic review
• well-being

Acknowledgements

The authors thank Research Secretary Line Jensen (MA) Department of Research, Horsens Hospital, Denmark for proofreading and the Department of Rehabilitation, Horsens Hospital, Denmark for financing this study; Bente Skovsbye Toft, DipMedRes, B.Sc, PT, PsC, MHH for engaging in constructive dialogue, contributing through all phases of the study.

Disclosure statement

The authors report no conflicts of interests and received no external funding.