Hand therapists' perspectives on the patient, environmental and contextual factors that influence recovery following distal radius fracture.

Abstract

Introduction: Distal radius fracture (DRF), a common upper extremity injury treated in outpatient hand therapy clinics, can lead to chronic pain and limitations in daily activities. Treatment often emphasises biomechanical aspects, like range of motion and oedema, while overlooking broader factors influencing recovery. This study explores therapists' perspectives on the recovery process in public healthcare and the contextual influences on therapeutic practices for patients with DRF.

Study design: Qualitative (Interpretive Description).

Methods: Hand therapists in Australia's public healthcare system were recruited through professional associations. Focus groups and follow-up interviews were conducted to explore the therapist's perspectives on patient recovery and the contextual factors influencing practice and outcomes. Reflexive thematic analysis was applied to analyse the data and develop themes.

Results: 37 participants contributed to eight focus groups and seven follow-up interviews. Two categories aligned with the research aims: (1) Perspectives on patient recovery and rehabilitation following DRF and (2) Perspectives on contextual and environmental influences shaping therapeutic approaches. Four main themes were generated: (1) recovery looks and feels different for everybody, (2) fundamental components of effective therapeutic approaches, (3) therapist experience makes a difference, and (4) it's the system: some things are out of our control.

Discussion: Although therapists tended to prioritise a biomechanical approach for DRF, most acknowledged the importance of an individualised, biopsychosocial approach aligned with the International Classification of Functioning, Disability and Health framework. Experienced therapists shifted towards patient-centred care and recognised the significance of function in rehabilitation. However, contextual and systematic barriers within the Australian public healthcare system influence the therapeutic approach and recovery. Ongoing research is needed to refine practice and align therapist-patient expectations for DRF management.