A grounded theory of taking control after fall-induced hip fracture

Purpose: We applied the grounded theory method to explore the post discharge concerns of older people after fall-induced hip fracture repair. It was anticipated that this understanding would increase awareness of issues that may impact on recovery and rehabilitation. Method: Semi-structured interviews were carried out with 19 older people after discharge home. Initially, purposive sampling guided data collection and thereafter theoretical sampling was employed. Interviews were analysed using the constant comparative method. Results: We generated a theory of how older people 'take control' after hip fracture. Conceptually, taking control was about 'balancing' and was both a process and a range of strategies. The three stages of the process that people moved through were: 'going under', 'keeping afloat' and 'gaining ground'. Nautical metaphors conceptualise the precarious and unstable conditions that older people faced as they struggled to regain their independence. Older people struggled to balance help and risk, in their attempt to manage their concerns relating to losing control of their future independence. Conclusion: Older people are vulnerable to losing a sense of control after a health trauma. This theory adds a new dimension to our understanding of recovery from hip fracture and highlights that older people and their families need tailored information and support to enable them to take control safely and appropriately.