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首页> 外文期刊>International journal of nursing studies >Comprehensive and subacute care interventions improve health-related quality of life for older patients after surgery for hip fracture: A randomised controlled trial
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Comprehensive and subacute care interventions improve health-related quality of life for older patients after surgery for hip fracture: A randomised controlled trial

机译：全面和亚急性护理干预措施可改善髋部骨折手术后老年患者健康相关的生活质量：一项随机对照试验

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Background: Elderly patients with hip fracture have been found to benefit from subacute care interventions that usually comprise usual care with added geriatric intervention, early rehabilitation, and supported discharge. However, no studies were found on the effects of combining subacute care and health-maintenance interventions on health outcomes for elders with hip fracture. Objectives: To compare the effects of an interdisciplinary comprehensive care programme with those of subacute care and usual care programmes on health-related quality of life (HRQoL) for elderly patients with hip fracture. Design: Randomised controlled trial. Settings: A 3000-bed medical centre in northern Taiwan. Participants: Patients with hip fracture (N = 299) were randomised into three groups: subacute care (n = 101), comprehensive care (n = 99), and usual care (n = 99). Methods: Subacute care included geriatric consultation, continuous rehabilitation, and discharge planning. Comprehensive care consisted of subacute care plus health-maintenance interventions to manage depressive symptoms, manage malnutrition, and prevent falls. Usual care included only 1-2 in-hospital rehabilitation sessions, discharge planning without environmental assessment, no geriatric consultation, and no in-home rehabilitation. HRQoL was measured using the Medical Outcomes Study Short-Form 36 Taiwan version at 1, 3, 6, and 12 months after discharge. Results: Participants in the comprehensive care group improved more in physical function, role physical, general health and mental health than those in the usual care group. The subacute care group had greater improvement in physical function, role physical, vitality, and social function than the usual care group. The intervention effects for both comprehensive and subacute care increased over time, specifically from 6 months after hip fracture onward, and reached a maximum at 12 months following discharge. Conclusions: Both comprehensive care and subacute care programmes may improve health outcomes of elders with hip fracture. Our results may provide a reference for health care providers in countries using similar programmes with Chinese/Taiwanese immigrant populations.
机译：背景：已发现老年髋部骨折患者可从亚急性护理干预措施中受益，这些干预措施通常包括常规护理，老年病干预，早期康复和辅助出院。但是，尚未发现将亚急性护理和健康维持干预措施相结合对髋部骨折老年人的健康结局的影响的研究。目的：比较跨学科综合护理计划与亚急性护理和常规护理计划对老年髋部骨折患者健康相关生活质量（HRQoL）的影响。设计：随机对照试验。地点：台湾北部拥有3000个床位的医疗中心。参与者：髋部骨折患者（N = 299）被随机分为三组：亚急性护理（n = 101），全面护理（n = 99）和常规护理（n = 99）。方法：亚急性护理包括老年咨询，持续康复和出院计划。全面护理包括亚急性护理和健康干预措施，以管理抑郁症状，管理营养不良和预防跌倒。通常的护理仅包括1-2次院内康复课程，没有环境评估的出院计划，没有老年咨询以及没有家庭康复。 HRQoL是在出院后1、3、6和12个月使用医学结果研究简表36台湾版进行的。结果：与常规护理组相比，综合护理组的参与者在身体机能，身体机能，总体健康和心理健康方面的改善更大。亚急性护理组在身体机能，角色生理，活力和社会功能方面比常规护理组有更大的改善。随时间推移，特别是从髋部骨折后的6个月起，全面和亚急性护理的干预效果均逐渐增强，并在出院后12个月达到最大。结论：全面护理和亚急性护理方案均可改善髋部骨折老年人的健康状况。我们的研究结果可能会为那些使用类似计划的中国/台湾移民人口国家的医疗服务提供者提供参考。

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