Predictors of functional activities after six months of surgery among older adults with hip fracture: A longitudinal study

• Main Authors: Li-Chu Wu, 伍麗珠
• Other Authors: Ruey-Hsia Wang
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/47rub7

博士 === 高雄醫學大學 === 護理學系博士班 === 104 === Older people are at a higher risk of hip fracture and hip fracture almost always requires surgical repair or replacement, followed by months of rehabilitation to back to their previous daily activity. Unfortunately, older people may have many factors which delayed their functional recovery. The aim of the study was to explore predictors of functional activities after six months of surgery among older adults with hip fracture. We conducted a longitudinal study. Data were collected between Jun 29, 2012 and Jun 28, 2013. We recruited 113 patients with hip fracture who were older than 65 years old in a medical center in Kaohsiung City in Taiwan. Data including patients’ demographic and disease related variables, pain visual analogue scale (VAS), Chinese-Canadian study of health and aging clinical frailty scale (CSHA-CFS), Mini Nutritional Assessment (MNA), Geriatric depression scale (GDS), activities of daily living (ADL) at pre-fracture, and instrumental activities of daily living (IADL) at pre-fracture were collected at the 3rd day after surgery. ADL and IADL were further collected at one month, three months, and six months after surgery. There were 69.9%, 83.2%, and 81.4% participants recovered to their pre-fracture ADL after surgery in one month, three months and six months, respectively. There were 75.2%, 76.1%, and 92.0% participants recovered to their pre-fracture IADL after surgery in one month, three months and six months, respectively. Furthermore, 17.7%, 29.2%, and 23.9% participants were totally independent at one month, three months, and six months after surgery, respectively. On the 3rd day after surgery, there were 105(93.0%) patients without depression, 76(67.3%) patients with malnutrition, and 73 (64.6%) patients without frail. The results demonstrated that gender, age, education, surgical type, pain level on the 3rd day after surgery had no significant differences in ADL and IADL after six months of surgery. However, ADL and IADL of participants with intertrochanteric fracture had significantly worse than those with femoral neck fractured after six months of surgery. The better the pre-fracture ADL and IADL participants had the higher scores on the ADL and IADL after six months of surgery. The depression status and frailty status three days after surgery had no significant differences in ADL and IADL after six months of surgery.The better nutritional status three days after surgery, participants had better ADL and IADL after six months of surgery. In stepwise multiple regression analysis, types of fracture, pre-fracture ADL, pre-fracture IADL and nutritional status after 3 days of surgery were significant predictors for ADL and IADL after six months of surgery. These four variables explained 37.7% of total variances. Pre-fracture IADL, nutritional status after three days of surgery, and the fracture type were significant predictors of ADL and IADL after six months of surgery. These three variables explained 44.1% of total variances. Based on the research results, we recommend that health-care personnel should assess the pre-fracture ADL and pre-fracture IADL level of older people with hip fracture and provide needed help in order to improve their ADL and IADL after six months of surgery. The health care providers should take care of the older adults who were in poor nutritional status after 3 days of surgery.