Caring for the frail: a qualitative study in an orthopaedic setting

Abstract Background The number of frail individuals is increasing, and the proportion of frail patients in hospital settings is high. Assessing patient frailty as a part of hospital care can guide clinicians in determining which interventions are needed and what to prioritise. Orthopaedic in-patients often experience both pain and mobility limitations, which, in combination with frailty, make these patients particularly vulnerable. There is limited knowledge regarding how staff working in orthopaedic acute care units understand frailty and how they adjust their clinical practices in response. The aim is to understand how healthcare professionals in an orthopaedic acute care unit perceive frailty and possibly adapt their clinical practices in response to it. Methods The study adopted a qualitative design and included 16 healthcare professionals from two hospitals. Semi-structured individual face-to-face interviews were conducted, digitally recorded, transcribed verbatim, and subsequently analysed using thematic analysis with an inductive approach. Results Two themes were developed during the analysis mirroring the healthcare professionals’ perceptions. The first is “Considering an individual frail” supported by the subthemes ”Describing frailty in different ways”, “Recognising vulnerability”, “Identifying the need for support”, and “Acknowledging frailty in different contexts ”. The second is “Caring for the frail”, supported by the subthemes “Understanding the concept of frailty”, “Assessing frailty”, “Taking frailty into account”, “Being one step ahead”, and “Having resource awareness”. Conclusions This study revealed that healthcare professionals perceive frailty as a broad and multidimensional concept that requires clearer specification to guide appropriate interventions. Participants emphasised that care is shaped primarily by individual needs rather than by frailty assessment, reflecting a person-centred approach. They also expressed a strong sense of responsibility toward frail patients and viewed hospital admission as an opportunity to identify and address unmet needs at home. While tools such as the Clinical Frailty Scale were viewed as limited in terms of capturing the full complexity of frailty, they were described as helpful for drawing attention to frailty and prompting deeper reflection. Trail registration https://researchweb.org/is/fourol/project/281574 Reg. no 28 15 74.