Functional Ability, Participation, and Health-Related Quality of Life After Hip Fracture

Social participation, positive affect, and negative affect in postoperative patients with hip fractures: A cross-sectional study

This study investigated the social participation, positive affect (PA), and negative affect (NA) of patients with hip fractures after surgery and determined their possible predictive factors. We used a cross-sectional study design to recruit 154 participants with hip fractures post-surgery. Assessment tools included the Barthel Index, the Automatic Thoughts Questionnaire, the Assessment of Life Habits, and the Positive and Negative Affect Schedule. Patients with better functioning in daily living activities experienced more social participation, higher PA, and lower NA. Patients with more positive automatic thoughts experienced more social participation and higher PA. Patients with more negative automatic thoughts experienced more social participation, lower PA, and higher NA. Early rehabilitation and psychosocial interventions should be provided for postoperative hip fracture patients to improve their activities of daily living and emotional well-being.

Associated Factors of Functional Ability in Older Persons Undergoing Hip Surgery Immediately Post-Hospital Discharge: A Prospective Study

BACKGROUND

hip fractures commonly have an impact on older adults' health. Surgical treatment aims to reduce pain and promote functional ability. However, developing adverse health outcomes or complications post-hip surgery may impede older patients' recovery to return to functional ability as pre-fracture. We aimed to examine the association of personal factors and adverse health outcomes during hospitalization and post-hospital discharge on the functional ability of older people undergoing hip surgery.

METHODS

a total of 120 older people with hip fractures who were scheduled for surgery at three tertiary hospitals and met the inclusion criteria were recruited for this study. Data were obtained at admission, before discharge, and during the two-week postoperative follow-up using the Demographic, Hip Dysfunction and Osteoarthritis Outcome Score, Joint Replacement, the Confusion Assessment Method (CAM) Thai version, and Health Outcome Questionnaires. Descriptive statistics and multiple logistic regression analyses were performed to analyze the data.

RESULTS

most participants were female, with a mean age of 78.10 years (range = 60-93; SD = 8.37). The most common adverse health outcome during hospitalization was urinary tract infection, followed by delirium, pneumonia, deep vein thrombosis, and surgical site infection. At two weeks immediately post-hospital discharge, 16 participants experienced unpleasant events, including delirium, urinary tract infection, surgical site infection, and pneumonia. The significant predictors of poor functional ability at two weeks immediately post-hospital discharge were old age (OR = 1.114, p = 0.001), subtrochanteric fracture (OR = 13.48, p = 0.008), and type of surgery (OR = 4.105, p = 0.049).

The impact of covid-19 lockdown on the Quality of life, meaningful activities, and frailty in community-dwelling octogenarians: A study in Belgium

OBJECTIVES

To investigate the impact of COVID-19 lockdown on quality of life (QoL), meaningful daily activities, and (pre)frailty in community-dwelling octogenarians.

METHODS

Cross-sectional design with bivariate and multiple linear regression modeling using a stepwise approach examining the level of QoL during the COVID-19 lockdown in a group of 215 community-dwelling octogenarians (M_age = 86.49 ± 3.02). A comprehensive set of biopsychosocial variables (FRAIL scale, general health, engagement in meaningful activities survey, questions on loneliness, and feelings) were used as explaining variables.

RESULTS

Particularly, a decrease in daily activities, social activities, and an increase in free times activities were observed, but the decrease in QoL could be explained by the meaningfulness in activities, together with experiencing emptiness in life, taking ≥ 4 medications a day and feeling down or depressed.

CONCLUSIONS

We tried to understand which components contribute to and might affect a person's QoL caused by restrictions imposed by the governance and its influence on the lives of the community-dwelling octogenarians. As such, this output could be a baseline for the development of minimally impacting countermeasures during future lockdowns.

CLINICAL IMPLICATIONS

Studying lifestyle changes and thus also variables related to QoL during a pandemic, may support policymakers and practitioners to develop relevant interventions.

Comparison of Effects between Combined Lumbar-Sacral Plexus Block plus General Anesthesia and Unilateral Spinal Anesthesia in Elderly Patients Undergoing Hip Fracture Surgery: A Pilot Randomized Controlled Trial

Purpose

Hip fracture is a common injury in geriatric populations, which is associated with poor quality of life. However, the ideal anesthesia technique for this disease is yet to be identified. This study aimed to compare the combined lumbar-sacral plexus block (CLSB) plus general anesthesia (bispectral index (BIS) 60–80) with the unilateral spinal anesthesia (SA) on activity of daily living in elderly patients undergoing hip fracture surgery.

Methods

A total of 124 elderly patients undergoing hip fracture surgery were randomly assigned to two groups. Patients in the SA group received light-specific gravity spinal anesthesia, and patients in the CLSB group received lumbar and sacral plexus block with general anesthesia (BIS 60–80). The primary outcomes were 30-day activity of daily living (ADL). The secondary outcomes were postoperative pain scores, postoperative delirium, in-hospital cost, and major complications.

Results

The ADL scores of postoperative day 30 (POD30) in the CLSB group are higher than those in the SA group (27.34 ± 7.01 versus 24.70 ± 6.40, P=0.045). Compared to preoperative ADL scores, there were higher increased scores in the CLSB group than in POD30 (CLSB group 8.09 ± 3.39 versus SA group 4.87 ± 3.90, P < 0.001). Mild-to-moderate pain did not have differences between the two groups (rest pain: 3 versus 2, P=0.344; motion pain: 5 versus 4, P=0.073). There were no significant differences in incidence of postoperative delirium, PONV, and other complications.

Conclusion

The unilateral SA can reduce the deterioration of ADL after hip fracture surgery and provide a better postoperative recovery.

Spiritual coping strategies and quality of life in older adults who have sustained a hip fracture: A cross-sectional survey

AIMS

To investigate the relationship between spiritual coping strategies and quality of life in persons with a hip fracture.

DESIGN

A correlational, cross-sectional survey design.

METHODS

The total population of Maltese-speaking adults over 65 years (N = 299), with a hip fracture receiving treatment in a public hospital in Malta in 2015, were invited. The WHOQOL-BREF questionnaire and the Spiritual Coping Strategies Scale were used.

RESULTS

A response rate of 51% (n = 147) was achieved. The poorest quality of life was for the physical and psychological domains. Spiritual coping strategies were associated with better quality of life with the exception of physical quality of life. Non-religious coping strategies were the stronger predictor of quality of life compared with religious coping strategies. The former predicted physical, psychological, environmental, social and overall quality of life.

CONCLUSION

Hip fractures have serious implications on quality of life which could be improved by promoting non-religious spiritual coping strategies.