From Hospital to Home After Lower-Extremity Open Reduction and Internal Fixation: Patients’ Experiences of Pain Self-Management and Trust-Building Discharge and Follow-Up Support

After lower-extremity open reduction and internal fixation (ORIF), patients often return home while pain, wound care, mobility restrictions, medication routines, and follow-up needs are still evolving. During this transition, trust in discharge information may shape how patients interpret symptoms, use analgesics, mobilise, involve family members, and decide when to seek help. This qualitative descriptive study explored patients’ experiences of pain self-management after lower-extremity ORIF in an Indonesian public hospital context, with attention to trust-building needs across discharge and early follow-up. Eighteen adults participated in individual face-to-face semi-structured interviews at an orthopaedic outpatient clinic. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Three themes were identified: (1) making sense of pain and medications amid uncertainty; (2) pain and fear shaping graded mobilisation; and (3) turning advice into action in real home contexts. Patients used discharge instructions as an initial reference point but often needed clearer guidance on expected versus concerning pain, safe analgesic use, mobilisation progression, and help-seeking. Family involvement was important, although family-related findings reflected patients’ accounts rather than direct caregiver perspectives. Findings suggest that trust-building discharge and follow-up support should provide practical symptom thresholds, medication counselling, task-specific mobilisation guidance, family-aligned education, and accessible escalation pathways to reduce uncertainty and support safer recovery at home.