Psychological care for patients after bone plate fixation

Patients after bone plate fixation often have negative emotions such as anxiety, depression and fear due to factors such as trauma, pain, limited movement and long rehabilitation period, and even affect rehabilitation compliance. Psychological care is an important part of rehabilitation treatment and requires multi-dimensional intervention to help patients establish a positive mindset. The following are the core contents and implementation strategies of psychological care:

First, common psychological problems after surgery and their causes

Anxiety and Fear

Reason: Concerns about the surgical outcome, the stability of internal fixation, and the risk of secondary injury; A decline in the ability to perform daily activities due to pain or functional limitations.

Symptoms: Repeatedly asking the doctor “Can the fracture heal?” and “Will the internal fixation break?”, having sleep disorders at night, and resisting rehabilitation training.

Depressive mood

Reasons: Social isolation, economic pressure and loss of working ability caused by long-term bed rest; Pessimistic expectations for the recovery process.

Symptoms: low mood, reduced interest, decreased appetite, and even a sense of guilt that “I have become a burden to the family”.

Dependent psychology

Reason: Excessive reliance on family members or medical staff, and lack of confidence in self-recovery.

Performance: Refusing to actively participate in rehabilitation training and demanding that family members handle all daily affairs.

Second, the core strategies of psychological care

Establish a trust relationship and strengthen doctor-patient communication

Active listening: Medical staff need to listen patiently to the patient’s main complaint and avoid interrupting or denying their emotions. For example, they can say, “I understand that you are very worried now…” Instead of “Don’t think too much”.

Transparency of information: Explain the surgical outcome, the stability of internal fixation and the rehabilitation process in plain language, for example, “The bone plate is like a steel bar, which can fix the fracture site, but it takes time for the bone to heal.”

Regular feedback: Enhance the patient’s confidence through the results of imaging examinations (such as “The fracture line is blurred, indicating that the bone is growing”).

Pain management, reducing negative emotional triggers

Multimodal analgesia: It combines drugs (such as non-steroidal anti-inflammatory drugs), physical therapy (such as cold compresses, percutaneous electrical nerve stimulation), and psychological intervention (such as deep breathing, meditation) to control pain.

Pain education: Inform patients that postoperative pain is a normal phenomenon, but if the pain score remains ≥4 points, they should report it in time to avoid increasing anxiety due to pain.

Set phased rehabilitation goals to enhance self-efficacy

Goal decomposition: Break down long-term rehabilitation goals (such as “resuming walking”) into short-term achievable small goals (such as “Be able to complete 10 straight leg raises this week”).

Positive feedback: Affirm every minor progress made by the patient, such as “You took the initiative to do ankle pump exercises today, which is very important for preventing blood clots.”

Family support and social participation

Family member training: Guide family members on how to assist patients in passive activities, emotional counseling and daily care to prevent excessive protection from leading to patient dependence.

Peer support: Organize patient exchange meetings to allow patients who have recovered well to share their experiences, such as “I can go back to work three months after the operation, so can you.”

Social resource utilization: Assist patients in applying for work injury compensation, assistive devices for the disabled or community rehabilitation services to alleviate economic pressure.

Cognitive behavioral intervention to correct negative thinking

Identify negative perceptions: Help patients recognize catastrophic thoughts such as “I’ll never get better” and “Internal fixation will definitely break”.

Thinking reconstruction: Use factual data to refute negative perceptions, such as “90% of patients with bone plate fixation can restore normal function.”

Relaxation training: Teach patients progressive muscle relaxation, mindfulness meditation and other methods to relieve anxiety.

Third, psychological care in special scenarios

Adolescent patients

Pay attention to academic interruptions: Assist in formulating online learning plans to prevent inferiority complex caused by long-term absence from classes.

Peer relationship maintenance: Encourage communication with friends via video to reduce feelings of loneliness.

Elderly patients

Coping with role transformation: Help patients accept the role change from “the pillar of the family” to “the person being cared for”, emphasizing their spiritual value to the family.

Preventing depression: Encourage participation in light household chores (such as folding clothes and organizing items) to enhance a sense of self-worth.

Patients with work-related injuries or traffic accidents

Legal and economic support: Assist in contacting lawyers or social security institutions, clarify the compensation process, and reduce economic anxiety.

Vocational rehabilitation: Communicate with the employer to formulate a return-to-work plan (such as gradually transitioning from light physical labor).

Fourth, taboos and precautions for psychological care

Avoid overcommitment

Avoid using absolute expressions such as “It will definitely recover completely” or “There will be no aftereffects at all”. Instead, emphasize that “most patients can restore their normal functions through standardized treatment”.

Respect the emotional expression of patients

Allow the patient to cry or vent their emotions. Avoid blaming “Why are you so vulnerable?” Instead, you can say, “Crying will make you feel better. I’m here with you.”

Pay attention to silent patients

Some patients may be reluctant to express their emotions due to introverted personality or cultural background, and active intervention is needed through observing behaviors (such as loss of appetite, sleep disorders).

Fifth, assessment and adjustment of psychological care

Regular psychological assessment

The psychological state of patients was quantified using tools such as the Hospital Anxiety and Depression Scale (HADS) and the Pain Catastrophization Scale (PCS), and evaluated every two weeks.

Dynamically adjust the nursing plan

If the patient persists in depression (HADS depression score ≥8 points) or shows suicidal tendencies, they should be referred to a psychiatrist for consultation in a timely manner. Drug treatment should be combined if necessary.