The objective of this study is to determine patterns in and factors influencing older persons' return of prior functional abilities following hip fracture. The results are anticipated to be a base for design of nursing interventions/programs/discharge plans that assist patients and families cope with this disabling event.
Specific aims are to examine: (a) patterns in resumption of activities of daily living (ADL), mobility, instrumental activities of daily living (IADL), and perceived return to normal in persons discharged to their own homes and to nursing homes; (b) the relevance to post-hospital progress of certain prior conditions and events, psychological states and perceived readiness for discharge of patients and their actual and potential family caregivers; (c) problematic aspects of the recovery period and (d) the congruence of patients' and caregivers' expectations of progress with actual progress. The design is prospective and descriptive, with data collection by interview at four points: pre-hospital discharge, 2, 8, and 14 weeks post discharge. The main sample will be 120 white femal patients age 60 and over admitted from home who have undergone surgical repair of a hip fracture and approximately 100-120 family members designated as caretakers after home discharge or temporary nursing home placement. A small comparison group of 20 male patients and their caregivers also will be followed. Patients will be drawn from orthopedic units in three community hospitals. Instruments are the ADL/Mobility and IADL Scales, and Activity Index (perceived return to normal), a short form of the Profile of Mood States, and parallel forms of Readiness for Discharge and Symptom Distress Congruency Scales. Additional patient data will be drawn from hospital records. Data analysis will include repeated measures analysis of variance with different grouping and control factors to address patterns in the resumption of activities, multiple regression and possibly time series analysis to address influence of independent variables, and correlations to examine relationships of mood states and incongruent expectations with progress in recovery.
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| Williams, M A; Oberst, M T; Bjorklund, B C et al. (1996) Family caregiving in cases of hip fracture. Rehabil Nurs 21:124-31, 138 |
| Williams, M A; Oberst, M T; Bjorklund, B C (1994) Early outcomes after hip fracture among women discharged home and to nursing homes. Res Nurs Health 17:175-83 |
| Williams, M A; Oberst, M T; Bjorklund, B C (1994) Posthospital convalescence in older women with hip fracture. Orthop Nurs 13:55-64 |
