Orthopaedic surgeons’ perceptions of frailty and frailty screening

Abstract Background Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clin...

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Main Authors: Mandy M. Archibald, Michael Lawless, Tiffany K. Gill, Mellick J. Chehade
Format: Article
Language:English
Published: BMC 2020-01-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-019-1404-8
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spelling doaj-71ce3e1fa59b456d9792f129cc2ff2ba2021-01-17T12:10:46ZengBMCBMC Geriatrics1471-23182020-01-0120111110.1186/s12877-019-1404-8Orthopaedic surgeons’ perceptions of frailty and frailty screeningMandy M. Archibald0Michael Lawless1Tiffany K. Gill2Mellick J. Chehade3for the Centre of Research Excellence in Frailty and Healthy Ageingfor the Centre of Research Excellence in Frailty and Healthy AgeingAdelaide Medical School, South Australian Health and Medical Research Institutefor the Centre of Research Excellence in Frailty and Healthy AgeingAbstract Background Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. Methods We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior Consultants, and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation. Results Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. Conclusions There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.https://doi.org/10.1186/s12877-019-1404-8FrailtyFrailty screeningQualitativeOrthopedicsFragility
collection DOAJ
language English
format Article
sources DOAJ
author Mandy M. Archibald
Michael Lawless
Tiffany K. Gill
Mellick J. Chehade
spellingShingle Mandy M. Archibald
Michael Lawless
Tiffany K. Gill
Mellick J. Chehade
Orthopaedic surgeons’ perceptions of frailty and frailty screening
BMC Geriatrics
Frailty
Frailty screening
Qualitative
Orthopedics
Fragility
author_facet Mandy M. Archibald
Michael Lawless
Tiffany K. Gill
Mellick J. Chehade
author_sort Mandy M. Archibald
title Orthopaedic surgeons’ perceptions of frailty and frailty screening
title_short Orthopaedic surgeons’ perceptions of frailty and frailty screening
title_full Orthopaedic surgeons’ perceptions of frailty and frailty screening
title_fullStr Orthopaedic surgeons’ perceptions of frailty and frailty screening
title_full_unstemmed Orthopaedic surgeons’ perceptions of frailty and frailty screening
title_sort orthopaedic surgeons’ perceptions of frailty and frailty screening
publisher BMC
series BMC Geriatrics
issn 1471-2318
publishDate 2020-01-01
description Abstract Background Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. Methods We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior Consultants, and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation. Results Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. Conclusions There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.
topic Frailty
Frailty screening
Qualitative
Orthopedics
Fragility
url https://doi.org/10.1186/s12877-019-1404-8
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