关键词: 老年人, 髋部骨折, 术后活动, 决策矛盾, 质性研究

Abstract:

Objective Based on the Common-Sense Model of Self-Regulation，this study explores the internal and external motivations of postoperative activity decision-making conflicts in elderly patients with hip fracture，to provide evidence for developing targeted interventions in clinical practice and improving postoperative activity compliance in elderly patients with hip fracture. Methods Using purposive sampling，13 elderly hospitalized patients who underwent hip fracture surgery at a tertiary hospital in Anhui Province from January to November 2025 were selected for semi-structured interviews. Traditional content analysis was employed to code the interview data and extract themes. Results A total of 3 primary themes and 17 secondary themes were extracted，including insufficient awareness of postoperative activities（misinterpretation of normal physiological responses，deviation in recovery time expectations，complete adherence to traditional beliefs，overestimation of activity risks，insufficient awareness of immobilization risks，insufficient awareness of activity benefits，lack of confidence in activity capabilities，over-identification with the patient role，and limited understanding of activity concept），impediments in self-regulation processes（dominance of negative emotions，inadequate planning ability，lack of execution skills，insufficient ability for dynamic adjustment，and inadequate evaluation ability），and limitations in support systems（inadequate family support，insufficient medical support，and lack of peer support）. Conclusion The decision-making conflict regarding postoperative activity in elderly patients with hip fractures stems from the interplay of insufficient awareness，impediments in self-regulation processes，and limitations in support systems. It is recommended that clinical practice adopts integrated intervention strategies，including correcting patients’ cognitive biases through individualized cognitive restructuring，providing patients with phased and structured guidance during the interpretation，coping，and evaluation stages，and promoting collaborative support from family，medical，and peer systems. This provides a basis for developing systematic intervention plans.

Key words: Aged, Hip Fracture, Postoperative Activity, Decision-Making Conflict, Qualitative Study