Comprehensive Care Improves Physical Recovery of Hip-Fractured Elderly Taiwanese Patients With Poor Nutritional Status

MUIR > Graduate Institute of Health Care > Department of Nursing > Papers > Item 987654321/2516

Please use this identifier to cite or link to this item: http://ir.meiho.edu.tw/ir/handle/987654321/2516

Title:	Comprehensive Care Improves Physical Recovery of Hip-Fractured Elderly Taiwanese Patients With Poor Nutritional Status
Authors:	Liu, Hsin-Yun Tseng, Ming-Yueh Li, Hsiao-Juan Wu, Chi-Chuan Cheng, Huey-Shinn Yang, Ching-Tzu Chou, Shih-Wei Chen, Ching-Yen Yea-Ing, L.Shyu
Keywords:	Hip-fractured elders;nutrition intervention;poor nutrition;physical function
Date:	2014
Issue Date:	2014-09-15T06:26:17Z (UTC)
Abstract:	Objectives: The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. Design: A secondary analysis of data from a randomized controlled trial with 24-month follow-up. Setting: A 3000-bed medical center in northern Taiwan. Participants: Subjects were included only if they had “poor nutritional status” at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. Interventions: The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Measurements: Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients’ baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Results: Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06e2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge, but not of those who had not yet recovered. Conclusions: An in-home program using the comprehensive care model with a nutritional component effectively improved the nutritional status of hip-fractured patients with poor nutrition. This comprehensive care intervention more effectively improved recovery of functional independence and balance for patients with recovered nutritional status.
Relation:	JAMDA 15 (2014) 416e422
Appears in Collections:	[Department of Nursing] Papers

Files in This Item:

File	Description	Size	Format
2014JAMDA-曾明月.pdf	fulltext	445Kb	Adobe PDF	0	View/Open

View Licence

Loading...