AUTHOR=Ansah John Pastor , Chia Aloysius Wei-Yan , Koh Vanessa Jean Wen , Lai Wei Xuan , Koh Joyce Suang Bee , Goh Kiat Sern , Yeo William , Howe Tet Sen , Seow Dennis Chuen Chai , Mamun Kaysar , Balasubramanian Diraviyam , Varman Surendra Doraiswamy , Yeo Andy Kuei Siong , Elamin Amal , Chan Angelique Wei-Ming , Matchar David Bruce TITLE=Systems modelling as an approach for eliciting the mechanisms for hip fracture recovery among older adults in a participatory stakeholder engagement setting JOURNAL=Frontiers in Rehabilitation Sciences VOLUME=4 YEAR=2023 URL=https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2023.1184484 DOI=10.3389/fresc.2023.1184484 ISSN=2673-6861 ABSTRACT=Introduction

Due to an aging population, the rising prevalence and incidence of hip fractures and the associated health and economic burden present a challenge to healthcare systems worldwide. Studies have shown that a complex interplay of physiological, psychological, and social factors often affects the recovery trajectories of older adults with hip fractures, often complicating the recovery process.

Methods

This research aims to actively engage stakeholders (including doctors, physiotherapists, hip fracture patients, and caregivers) using the systems modeling methodology of Group Model Building (GMB) to elicit the factors that promote or inhibit hip fracture recovery, incorporating a feedback perspective to inform system-wide interventions. Hip fracture stakeholder engagement was facilitated through the Group Model Building approach in a two-half-day workshop of 25 stakeholders. This approach combined different techniques to develop a comprehensive qualitative whole-system view model of the factors that promote or inhibit hip fracture recovery.

Results

A conceptual, qualitative model of the dynamics of hip fracture recovery was developed that draws on stakeholders' personal experiences through a moderated interaction. Stakeholders identified four domains (i.e., expectation formation, rehabilitation, affordability/availability, and resilience building) that play a significant role in the hip fracture recovery journey..

Discussion

The insight that recovery of loss of function due to hip fracture is attributed to (a) the recognition of a gap between pre-fracture physical function and current physical function; and (b) the marshaling of psychological resilience to respond promptly to a physical functional loss via uptake of rehabilitation services is supported by findings and has several policy implications.