A qualitative study of clinicians' experience of a clinical trial for displaced distal radius fractures.

Advanced Search

Emma E Phelps, Elizabeth Tutton, Matthew L Costa, Juul Achten, Phoebe Gibson, Daniel C Perry

Author Information

Emma E Phelps: Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK. ORCID
Elizabeth Tutton: Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK. ORCID
Matthew L Costa: Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK. ORCID
Juul Achten: Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK. ORCID
Phoebe Gibson: Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Daniel C Perry: Kadoorie, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK. ORCID

PMID: 38636944 DOI: 10.1302/2633-1462.54.BJO-2023-0158

Aims: The aim of this study was to explore clinicians' experience of a paediatric randomized controlled trial (RCT) comparing surgical reduction with non-surgical casting for displaced distal radius fractures.
Methods: Overall, 22 staff from 15 hospitals who participated in the RCT took part in an interview. Interviews were informed by phenomenology and analyzed using thematic analysis.
Results: Analysis of the findings identified the overarching theme of "overcoming obstacles", which described the challenge of alleviating staff concerns about the use of non-surgical casting and recruiting families where there was treatment uncertainty. In order to embed and recruit to the Children's Radius Acute Fracture Fixation Trial (CRAFFT), staff needed to fit the study within clinical practice, work together, negotiate treatment decisions, and support families.
Conclusion: Recruiting families to this RCT was challenging because staff were uncertain about longer-term patient outcomes, and the difficulties were exacerbated by interdisciplinary tensions. Strong family and clinician beliefs, coupled with the complex nature of emergency departments and patient pathways that differed site-by-site, served as barriers to recruitment. Cementing a strong research culture, and exploring families' treatment preferences, helped to overcome recruitment obstacles.

No authors listed . Children��s Radius Acute Fracture Fixation Trial. A multi-centre prospective randomised non-inferiority trial of surgical reduction versus non-surgical casting for displaced distal radius fractures in children . NDORMS . 2020 . https://www.ndorms.ox.ac.uk/research/clinical-trials/current-trials-and-studies/crafft ( date last accessed 26 March 2024 ).
Aitken AP . Further observations on the fractured distal radial epiphysis . J Bone Joint Surg Am . 1935 ; 17-A : 922 �� 927 .
Bergkvist A , Lundqvist E , Pantzar-Castilla E . Distal radius fractures in children aged 5-12 years: a Swedish nationwide register-based study of 25 777 patients . BMC Musculoskelet Disord . 2023 ; 24 ( 1 ): 560 . 10.1186/s12891-023-06680-8 37430230
Phelps EE , Tutton E , Costa ML , Achten J , Moscrop A , Perry DC . Protecting my injured child: a qualitative study of parents�� experience of caring for a child with a displaced distal radius fracture . BMC Pediatr . 2022 ; 22 ( 1 ): 270 . 10.1186/s12887-022-03340-z 35549910
Lawton J , Kirkham J , White D , Rankin D , Cooper C , Heller S . Uncovering the emotional aspects of working on a clinical trial: a qualitative study of the experiences and views of staff involved in a type 1 diabetes trial . Trials . 2015 ; 16 : 3 . 10.1186/1745-6215-16-3 25566971
Skea ZC , Treweek S , Gillies K . ��It��s trying to manage the work��: a qualitative evaluation of recruitment processes within a UK multicentre trial . BMJ Open . 2017 ; 7 ( 8 ): e016475 . 10.1136/bmjopen-2017-016475 28801422
Phelps EE , Tutton E , Griffin X , Baird J , TrAFFix study co-applicants . Facilitating trial recruitment: a qualitative study of patient and staff experiences of an orthopaedic trauma trial . Trials . 2019 ; 20 ( 1 ): 492 . 10.1186/s13063-019-3597-8 31399134
Scantlebury A , McDaid C , Brealey S , et al. Embedding qualitative research in randomised controlled trials to improve recruitment: findings from two recruitment optimisation studies of orthopaedic surgical trials . Trials . 2021 ; 22 ( 1 ): 461 . 10.1186/s13063-021-05420-4 34274006
Heidegger M , Stambaugh J . Being and Time: A Translation of Sein Und Zeit . Albany, NY : State University of New York Press , 1996 .
Braun V , Clarke V , Hayfield NT . Thematic Analysis . In : Liamputtong P . ed . Handbook of Research Methods in Health Social Sciences . 2019 .
Lincoln Y , Guba E . Naturalistic Enquiry . Beverly Hills, CA : Sage Publications , 1985 .
Tong A , Sainsbury P , Craig J . Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups . Int J Qual Health Care . 2007 ; 19 ( 6 ): 349 �� 357 . 10.1093/intqhc/mzm042 17872937
Short A , Jackson W , Nugus P . Expanding clinical research capacity through a community of practice (CoPER) . Nurse Educ Pract . 2010 ; 10 ( 1 ): 52 �� 56 . 10.1016/j.nepr.2009.03.016 19427268
Griffin XL , Costa ML , Phelps E , et al. Retrograde intramedullary nail fixation compared with fixed-angle plate fixation for fracture of the distal femur: the TrAFFix feasibility RCT . Health Technol Assess . 2019 ; 23 ( 51 ): 1 �� 132 . 10.3310/hta23510 31549959
Papiez K , Tutton E , Phelps EE , et al. A qualitative study of parents�� and their child��s experience of a medial epicondyle fracture . Bone Jt Open . 2021 ; 2 ( 6 ): 359 �� 364 . 10.1302/2633-1462.26.BJO-2020-0186.R1 34078095

Journal Article

No available data.

OpenLB
Open Library of Bioscience