Development of an electronic decision aid that prepares adults with distal radius fractures in choosing the optimal rehabilitation after volar plate fixation

Distal radius fractures (DRFs) are among the most common adult fractures with approximately 20,000 cases per year in Denmark. Annually 5,000 patients are surgically treated to enable early performance of activities. Overall, 45% of patients who were not offered supervised rehabilitation post-surgery reported disability at 6 months. Due to weak recommendations regarding who might benefit from supervised rehabilitation, this decision is preference sensitive. Decision aids (DAs) can prepare patients in making an informed choice according to their resources and preferences. Giving patients the type of rehabilitation that suits them best could facilitate an earlier return to everyday life.
This PhD-project will develop an electronic DA (EDA) that prepares adults with surgically treated DRF to choose the best type of rehabilitation based on an evidence-based process framework. A scoping review could gain insight into predictive factors associated with functioning. A qualitative mixed-methods study will develop the EDA through collaborative processes with stakeholders. Finally, a multiple case study will evaluate the patients’ experiences of using the EDA, participation in SDM, functioning and health-related quality of life.
The EDA is expected to be implemented as common practice. Potentially, the results can be used to develop a generic EDA for patients with hand-related disorders.

Håndledsbrud er én af de hyppigste frakturer blandt voksne. Behovet for genoptræning efter operation afgøres oftest af sundhedsprofessionelle baseret på håndleddets bevægelighed og smerter. Alligevel oplever 45% af de patienter, som ikke tilbydes genoptræning, nedsat funktionsevne herunder problemer med at udføre hverdagsaktiviteter.
Patienternes værdier, præferencer og ressourcer er vigtige parametre, når der skal tages stilling til den bedste genoptræning for den enkelte patient fx superviseret genoptræning eller selvtræning. Patienterne er dog sjældent forberedte på, at der skal tages en beslutning om deres genoptræning, hvilke muligheder for genoptræning der findes og de har ikke overvejet deres værdier og præferencer ift. de forskellige genoptræningsmuligheder.
Patientinformationsmateriale i form af et beslutningsstøtteværktøj, kan forberede patienten til fælles beslutningstagen, hvor patienten sammen med en sundhedsprofessionel tager stilling til den bedste genoptræning.
Formålet med projektet er derfor at:
1) udvikle, teste og evaluere patientinformationsmateriale som et webbaseret beslutningsstøtteværktøj
2) afprøve og evaluere fælles beslutningstagen faciliteret af et beslutningsstøtteværktøj i klinisk praksis