Discharge transition experienced by older Korean women after hip fracture surgery: a qualitative study

Abstract Background This study aimed to explore older Korean women’s discharge transition experiences after hip fracture surgery. Methods This was a descriptive qualitative study. Face-to-face interviews following hip fracture surgery were conducted on 12 women aged 65–87 years. Data were collected 1 to 2 days before discharge and again 4 weeks after discharge following hip fracture surgery, and were analyzed using qualitative content analysis. Results Four main themes were identified: (1) challenge of discharge transition: unprepared discharge, transfer into other care settings, and eagerness for recovery; (2) physical and psychological distress against recovery: frail physical state and psychological difficulties; (3) dependent compliance: absolute trust in healthcare providers, indispensable support from the family, and passive participation in care; and (4) walking for things they took for granted: hope of walking and poor walking ability. Conclusions After their hip fracture surgeries, older women hoped to be able to walk and perform simple daily chores they previously took for granted. Considering the physical and psychological frailty of older women undergoing hip surgery, systematic nursing interventions including collaboration and coordination with other healthcare professionals and settings are necessary to ensure the quality of continuous care during their post-surgery discharge transition. Encouraging partial weight bearing and initiating intervention to reduce fear of falling at the earliest possible time are essential to attain a stable discharge transition. Additionally, older women should be invited to participate in their care, and family involvement should be encouraged during the discharge transition period in South Korea.

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Discharge Transition Experienced by Korean Older Adults After Hip Fracture Surgery: A Qualitative Study

10.21203/rs.3.rs-130312/v1 ◽

2020 ◽

Author(s):

YoungJi Ko ◽

JuHee Lee ◽

Seung-Hoon Baek

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Qualitative Study ◽

Family Involvement ◽

Transitional Care ◽

Qualitative Content Analysis ◽

Walking Ability ◽

Hip Fracture Surgery ◽

Discharge Transition ◽

Fracture Surgery

Abstract Background: This study aimed to explore Korean older adults’ experience with discharge transition after hip fracture surgery. Methods: This was a descriptive qualitative study. Face-to-face interviews following hip fracture surgery were conducted with 12 participants. Data were collected one to two days before discharge and again four weeks after discharge following hip fracture surgery, and were analyzed using qualitative content analysis.Results: Four main themes were identified: (1) Challenge of discharge transition: unprepared discharge, transfer into other care settings, and eagerness for recovery; (2) Physical and psychological distress against recovery: frail physical state and psychological difficulties; (3) Dependent compliance: absolute trust in healthcare providers, indispensable support from the family, and passive participation in care; and (4) Walking for things they took for granted: hope of walking and poor walking ability.Conclusions: After the hip fracture surgery, older adults hoped to be able to walk to perform the simple daily chores they earlier took for granted. Considering the physical and psychological frailty of older adults, systematic nursing interventions, including collaboration and coordination with other healthcare professional and settings, are necessary during discharge transition after hip fracture surgery. Invitation for care participation by older adults as well as family involvement should be considered at discharge transitional care in South Korea.

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Older adults’ perceptions of early rehabilitation and recovery after hip fracture surgery: a UK qualitative study

Disability and Rehabilitation ◽

10.1080/09638288.2020.1783002 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Jessica Southwell ◽

Chris Potter ◽

David Wyatt ◽

Euan Sadler ◽

Katie Jane Sheehan

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Qualitative Study ◽

Early Rehabilitation ◽

Hip Fracture Surgery ◽

Fracture Surgery

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Vitamin D Levels and Nutritional Risk Index: Mobility and Mortality After Hip Fracture Surgery (P01-013-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz028.p01-013-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Lihong Hao ◽

Yvette Schlussel ◽

Jeffrey Carson ◽

Sue Shapses

Keyword(s):

Vitamin D ◽

Hip Fracture ◽

Vitamin D Deficiency ◽

Risk Index ◽

Nutritional Risk ◽

Walking Ability ◽

Hip Fracture Surgery ◽

Vitamin D Levels ◽

Nutritional Risk Index ◽

Fracture Surgery

Abstract Objectives Hip fractures are associated with a high rate of morbidity and mortality, and successful ambulation after surgery is an important outcome in this patient population. This study aims to determine whether 25-hydroxyvitamin D (25(OH)D) or the Geriatric Nutritional Risk Index (GNRI) is associated with short term mortality or ability to walk after hip fracture surgery. Methods Patients undergoing hip fracture repair were included in this study. Mortality and walking ability were assessed at 30 and 60 days after hip fracture surgery. Pre-operative serum albumin and 25(OH)D were measured. Patients were characterized with 25(OH)D <12 ng/mL, 12 to <20, 20 to <30 or ≥30. GNRI was calculated from albumin and body weight and patients were categorized into major/moderate nutritional risk (<92), low risk (92 to <98) or in good nutritional status (≥98). Results Of the 290 patients (82 ± 7 years, BMI 25 ± 5 kg/m2), 73% were females. Compared to patients with vitamin D deficiency (<12 ng/mL), those with vitamin D levels in higher categories had increased ability to walk at 30 days (P = 0.031): 12 to <20 ng/ml (adjusted odds ratio = 2.61; 95% confidence interval = 1.13–5.99); 20 to <30 ng/ml (3.48; 1.53–7.95); ≥30 ng/ml (2.84; 1.12–7.20). In addition, patients also had increased mobility at 60 days in these same higher vitamin D categories 12 to <20 (2.67; 1.14–6.25); 20 to <30 (3.42; 1.46–8.00); ≥30 ng/ml (3.67; 1.37–9.82) compared to the reference group (<12 ng/mL; P = 0.028). There was no association of vitamin D with mortality at either time point. GNRI was not associated with mortality or walking ability. Conclusions In patients with hip fracture, vitamin D deficiency (<12 ng/mL) was associated with reduced ambulation after surgery, whereas GNRI was not associated with any outcomes. Mechanisms that attenuate mobility due to vitamin D deficiency should be examined in future studies. Funding Sources ONE Nutrition Grant to SAS and JLC.

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Older patients' perception of their own capacity to regain pre-fracture function after hip fracture surgery – an explorative qualitative study

International Journal of Orthopaedic and Trauma Nursing ◽

10.1016/j.ijotn.2016.04.005 ◽

2017 ◽

Vol 24 ◽

pp. 50-58 ◽

Cited By ~ 13

Author(s):

Berit Gesar ◽

Ami Hommel ◽

Hanne Hedin ◽

Carina Bååth

Keyword(s):

Hip Fracture ◽

Qualitative Study ◽

Older Patients ◽

Hip Fracture Surgery ◽

Fracture Function ◽

Fracture Surgery

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Risk Factors Affecting Postoperative Walking Ability Following Hip Fracture Surgery in the Elderly

Orthopedic & Muscular System ◽

10.4172/2161-0533.1000209 ◽

2016 ◽

Vol 05 (02) ◽

Cited By ~ 1

Author(s):

Takako Nagai ◽

Akihiro Okawa

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

The Elderly ◽

Walking Ability ◽

Factors Affecting ◽

Hip Fracture Surgery ◽

Surgery In The Elderly ◽

Fracture Surgery

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Association between Intravenous Iron Therapy and Short-term Mortality Risk in Older Patients Undergoing Hip Fracture Surgery: An Observational Study

10.21203/rs.3.rs-320715/v1 ◽

2021 ◽

Author(s):

Silas Zacharias Clemmensen ◽

Kristian Hay Kragholm ◽

Dorte Melgaard ◽

Lene Torp Hansen ◽

Johannes Riis Jensen ◽

...

Keyword(s):

Hip Fracture ◽

Intravenous Iron ◽

Iron Therapy ◽

Short Term ◽

Treatment Groups ◽

Hip Fracture Surgery ◽

Post Surgery ◽

Short Term Mortality ◽

Intravenous Iron Therapy ◽

Fracture Surgery

Abstract Background: Anemia is common among ortho-geriatric hip fracture patients and is associated with prolonged recovery and increased postoperative mortality rate. Intravenous iron seems to increase hemoglobin recovery and reduce the mortality rate in patients undergoing orthopedic surgeries. This study investigated the association between short-term mortality risk and intravenous iron therapy in older patients undergoing hip fracture surgery.Methods: This observational study included 210 patients undergoing hip fracture surgery from July 2018 to Maj 2020. These 210 patients were alive and had a hemoglobin ≤ 6.5mmol/L on the 3rd postoperative day. In May 2019 a local intravenous iron therapy protocol was implemented and recommended intravenous iron (Monofer ©) if hemoglobin on the 3rd postoperative day was ≤ 6.5 mmol/L. According to treatment of postoperative anemia between 1st and 3rd day post-surgery, the patients were divided into four groups: No treatment (n=52), blood transfusion (n=38), IV Monofer (n=80) and blood transfusion & IV Monofer (n=40). Primary outcome was 30-day mortality post-surgery. The secondary outcome was the impact on hemoglobin level 14-30 days postoperatively. Multivariable Cox regression was used to estimate the 30-day mortality standardized for covariates. Results: Of 210 patients, 17 (8.1%) died within 30-days after surgery. There was a significantly lower mortality among the patients who received IV Monofer compared to those who received no treatment (HR: 0.17, 95% CI: [0.03-0.93], P = 0.041). Among the 86 patients with available hemoglobin measurements within 14 to 30 days post-surgery, there was no significant difference in hemoglobin level between the various treatment groups (mean 6.6 mmol/L, P = 0.1165).Conclusion: IV Monofer on the 3rd postoperative day in older hip fracture patients seemed to reduce 30-day mortality compared with no treatment. No significant differences in hemoglobin levels between 14-30 days post-surgery across treatment groups were found, although this was assessed in a subset of patients with available hemoglobin levels warranting further study. Trial registration: NA

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Self-Efficacy Care Program for Older Adults Receiving Hip-Fracture Surgery

Clinical Nursing Research ◽

10.1177/10547738211001486 ◽

2021 ◽

pp. 105477382110014

Author(s):

Shu-Fen Su ◽

Shu-Ni Lin ◽

Chia-Sui Chen

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Hip Fractures ◽

Self Efficacy ◽

Short Form ◽

Care Program ◽

Control Group ◽

Hip Fracture Surgery ◽

Post Surgery ◽

Fracture Surgery

Hip fractures decrease older adults’ physical activity and quality of life (QoL). However, no current self-efficacy care programs are managed by clinical nurses, and thus no studies have measured their effects on self-care self-efficacy (SCSE). Hence, this quasi-experimental study determined the effectiveness of a self-efficacy care program (SECP) in 104 older adults receiving hip-fracture surgery who were divided into intervention and control groups. The Strategies Used by People to Promote Health and Short Form-36 were administered pre-surgery and at 1 and 3-month intervals post-surgery. The SCSE and QoL of the SECP group were significantly better than the control group at 1- and 3-month follow-ups post-surgery. Both groups’ QoL decreased at one-month post-surgery but increased by 3-months post-surgery. The SECP group had higher psychological QoL than the control group post-surgery. This intervention increased the SCSE and QoL of older adults with hip fractures and improved post-operative care.

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EFFECTS OF FRAGILITY FRACTURE INTEGRATED REHABILITATION MANAGEMENT HIP FRACTURE IN PAKISTANI OLDER ADULTS

QUALITY OF LIFE IN PATIENTS WITH NEUROGENIC COMMUNICATION DISORDER ◽

10.52567/trj.v5i01.55 ◽

2021 ◽

Vol 5 (1) ◽

pp. 192-197

Author(s):

Anam Aftab ◽

◽

Shaista Habibullah ◽

Nimra Ilyas Bhutta ◽

◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Hip Fracture ◽

Fragility Fracture ◽

Personal Hygiene ◽

Walking Ability ◽

Rehabilitation Management ◽

Hip Fracture Surgery ◽

Fracture Surgery

Objective: to evaluate the effectiveness of fragility Fracture Integrated Rehabilitation Management (FIRM) on older adults of Pakistan after hip fracture surgery. Methodology: A one-group pretest–posttest designwas conducted at the National Institute of Rehabilitation Medicine (NIRM), Islamabad from March 2020 to May 2021.. A n=11 participants with age above 55 years, both male and female, with confirming diagnosed cases of hip fracture were included. Every participats receveied 10 sesssions of Fragility Fracture integrated Rehabilitation Management (FIRM) program in two weeks. Data was collected at baseline at 2nd day and after 10th session on 15th day, through the KOVAL scale to assess the walking ability, the Functional Ambulatory Category (FAC) to assess the level of independence, the modified Barthel index (MBI) for activities of daily living (ADLs), and quality of life (QoL) was assessed by EQ-5D. Data were analyzed by using SPSS Version 21. Result: the mean age 76.45±9.32, of which n=6 (54.6%) were males and n=5(45.4%) were females. after 10th sessions the QoL on EQ-5D, ambulation on FAC and KOVAL scale and the ADL on MBI were significantly improved (p<0.05) with large effect size, except for the anxiety domain of EQ5D and subdomains of MBI; Personal hygiene, feeding, Bowel control, bladder control, Wheelchair, and Chair & bed transfer showed no significant change (p>0.05). Conclusion: FIRM care is found to be effective in improving the walking ability, functional status, ADLs and quality of life in geraiatric population following a hip fracture surgery

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