Evaluation of bone mineral density and metabolic abnormalities associated with low-energy hip fractures

Screaming silences: lessons from the application of a new research framework

BACKGROUND

The Silences Framework ( Serrant-Green 2011 ) originated from research exploring ethnicity, gender and sexual health decision-making, and provides a useful tool for researching underrepresented groups and topics.

AIM

To present the lessons learned from the application of the Silences Framework in the context of a qualitative study exploring the experiences of people under the age of 60 recovering from a fragility hip fracture.

DISCUSSION

The authors explore current conceptions of marginalisation in healthcare with reference to nursing research and provide practical tips for others interested in applying and further testing the framework.

CONCLUSION

The framework is likely to be attractive to nurses as it is underpinned by core nursing values, such as advocacy-based action. It places participant and public voices at the centre of the research and resembles the familiar nursing process. The structure and flexibility it offers also makes it relevant for new and experienced researchers in a variety of contexts.

IMPLICATIONS FOR PRACTICE

Critical analysis of the initial application of the Silences Framework in a different setting to the one in which it was developed indicates it offers a beneficial addition to the research toolkit. Its limited use to date means its relevance for nursing and potential for further development have not yet been fully established. It should be tested more widely and in other contexts.

Silent slips, trips and broken hips in the under 60s: A review of the literature

This critical review of the literature regarding the recovery experiences and healthcare needs of people under 60 following a fragility hip fracture seeks to identify the associated implications for nursing practice and inform care delivery. Forty papers were included following a structured database, citation and grey literature search and filtering of results in line with specified inclusion criteria. Hip fracture is a common, serious and complex injury and an important cause of morbidity, mortality and rising healthcare costs worldwide. This review indicates that although commonly associated with the elderly, incidence and impact in the under 60s has been under-explored. Current health policy, professional and social norms almost exclusively focus on the elderly, surgical interventions and short-term outcomes, rendering the under 60s an inadvertently marginalised, relatively 'silent' sub-set of the hip fracture population. Nurses must be aware, however, of the different recovery needs of this younger group. The limited evidence available indicates these include work related needs and long term physical and psychosocial limitations in this socially and economically active group. Priorities are identified for research to inform policy and practice. Meanwhile, nurses can address the needs of this group by listening to and involving them and their families as healthcare partners.