Challenges of self-care at home after orthopaedic implant surgery in Indonesia: A qualitative study

Aim. This study explored self-care challenges at home after orthopaedic implant surgery among Indonesian adults as expressions of patient vulnerability and examined the ethical implications for nursing responsibilities during the transition from hospital to home. Material and methods. A qualitative descriptive phenomenological design was used, involving in-depth semi-structured interviews with 18 adults, conducted two to six weeks after open reduction and internal fixation for lower-extremity fractures at a public hospital in Jakarta. Data were analysed using reflexive thematic analysis. Results. Participants described a fragile recovery space characterised by poorly controlled pain and sleep disturbance, movement-related anxiety and kinesiophobia, uncertainty about wound care and safe activity, and heavy reliance on unprepared family caregivers experiences that amounted to perceived ethical neglect. Participants also expressed a strong wish for simple digital tools that would sustain contact with nurses after discharge. Conclusions. Current discharge practices risk ethical neglect of patients and their families by transferring complex care to the home without adequate preparation. Nurses should reconceptualise discharge as transitional protection, combining family-inclusive education with low-threshold digital support to deliver the “strong care” required by these vulnerable populations.