Difficulties associated with wrist disorders - a qualitative study

Objective: To explore the range of functional difficulties and compensatory mechanisms reported by individuals with a wrist disorder, to provide a basis for development of a patient-focused outcome instrument. Design: Descriptive study using a qualitative, interview-based framework. Setting/subjects: A volunteer sample of individuals, who were diagnosed with a unilateral, localized wrist disorder, were recruited from a wide range of health care settings situated in different socio-economic and geographic areas of Adelaide, Australia, Recruitment continued until theoretical saturation of the data occurred. Interventions: Semi-structured, audiotaped interviews were conducted with each individual to elicit information concerning 'how your wrist disorder has affected your ability to perform daily activities'. Main outcome measures: Trends regarding reporting of difficult activities and compensatory mechanisms used, Results: Forty-two individuals were interviewed. This was the point where theoretical saturation of research information had been reached. A few individuals reported difficulty with functional tasks prior to wrist injury. Following diagnosis, a wide range of difficulties, which included heavy, gross and fine motor activities, was reported. Compensatory mechanisms were used by all individuals, with requesting someone else to do the task, using the other hand, and using other parts of the body to lift or grasp being the most common. Conclusions: Current wrist outcome instruments do not contain the full range of difficult activities that were elicited from our sample, which casts doubt on these instruments' ability to fully measure change in capacity. Our results should provide the basis for the development of a relevant, sensitive, patient-focused outcome instrument.