Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: A randomised controlled trial

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Title:	Enhanced interdisciplinary care improves self-care ability and decreases emergency department visits for older Taiwanese patients over 2 years after hip-fracture surgery: A randomised controlled trial
Authors:	Yea-Ing L. Shyu;Jersey Liang;Ming-Yueh Tseng;Hsiao-Juan Li;Chi-Chuan Wue;Huey-Shinn Cheng f;Shih-Wei Chou g;Ching-Yen Chen h;Ching-Tzu Yang
Keywords:	Functional performance;Hip fracture;Older persons;Rehabilitation
Date:	2016
Issue Date:	2016-08-28T01:50:19Z (UTC)
Abstract:	Background: Little evidence is available on the longer-term effects (beyond 12 months) of intervention models consisting of hip fracture-specific care in conjunction with management of malnutrition, depression, and falls. Objective: To compare the relative effects of an interdisciplinary care, and a comprehen- sive care programme with those of usual care for elderly patients with a hip fracture on self-care ability, health care use, and mortality. Design: Randomised experimental trial. Setting: A 3000-bed medical centre in northern Taiwan. Participants: Patients with hip fracture aged 60 years or older (N = 299). Method: Patients were randomly assigned to three groups: comprehensive care (n = 99), interdisciplinary care (n = 101), and usual care (control) (n = 99). Usual care entailed only one or two in-hospital rehabilitation sessions. Interdisciplinary care included not only hospital rehabilitation, but also geriatric consultation, discharge planning, and 4-month in-home rehabilitation. Building upon interdisciplinary care, comprehensive care extended in-home rehabilitation to 12 months and added management of malnutrition and depressive symptoms, and fall prevention. Patients’ self-care ability was measured by activities of daily living and instrumental activities of daily living using the Chinese Barthel Index and Chinese version Instrumental Activities of Daily Living scale, respectively. Outcomes were assessed before discharge, and 1, 3, 6, 12, 18, 24 months following hip fracture. Hierarchical linear models were used to analyse health outcomes and health care utilisation, including emergency department visit and hospital re-admission.
Relation:	International Journal of Nursing Studies 56 (2016) 54–62
Appears in Collections:	[Department of Nursing] Papers

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