Patients' and carers' perspectives on unrestricted weight-bearing and early mobilisation after hip fracture surgery in Saudi Arabia: a qualitative study.

Abstract

This study explored how patients and carers experienced weight-bearing instructions and mobilisation timing following hip fracture surgery. It also examined their views on unrestricted weight-bearing and early mobilisation and perceived barriers to these practices. Semi-structured interviews were conducted with 25 participants (18 carers, 7 patients) from Saudi Arabia's healthcare systems. The data were analysed using inductive thematic analysis. Participants viewed unrestricted weight-bearing and early mobilisation as important when prescribed by clinicians, reflecting strong trust in professional judgement. However, their experiences showed inconsistency in clinical instructions and how these were understood and implemented. Implementation was shaped by clinical instructions, clarity of communication, perceived safety, and patients' physical capacity and psychological state. Concerns about falls were mostly reported by carers as barriers to mobilisation, although some patients also described fear shaped by past injuries, difficult recoveries, or uncertainty about undiagnosed complications. Carers played a key role in encouraging mobilisation, adapting instructions, and maintaining continuity of care when weight-bearing and mobilisation were challenging for patients. To support adherence to weight-bearing and mobilisation instructions, clinicians should provide timely, consistent prescriptions aligned with evidence-based guidance. Communication must be inclusive to support understanding, confidence, and autonomy among patients and carers.