Effect of Pre and Post Hospital Discharge Instructions on Functional Abilities of Patients with Hip Fractures

Abstract

Background: Hip fracture represents one of the commonest causes of disability and hospitalization in the patient population, resulting in increased morbidity and mortality and impaired functional capacity, particularly for basic and instrumental activities of daily living (IADLs). The aim of this study was to evaluate the effect of pre and post hospital discharge instructions on functional abilities of patients with hip fractures. Design: A quasi experimental research design was used in this study. Setting: The study was conducted in the orthopedic department and orthopedic outpatient clinic at El-Demerdash University Hospital. Subjects: A purposive sample of 60 patients with hip fractures divided into two equal groups (study and control) where each group consists of 30 patients. The experimental group received the discharge instructions beside routine care in hospital, whereas, control group received only the routine hospital care according to inclusion and exclusion criteria. Tools: Five tools were used for data collection I. Patients` Structured Interview Questionnaire. II. Short Portable Mental Status Scale (SPMSS). III. Barthel Index of Activities of Daily Living. IV. Lawton and Brody Instrumental Activities of Daily Living Scale Lawton and Brody Instrumental Activities of Daily Living Scale .V. Self-care practices of patients with hip fracture checklist. Results: The total activities of daily living (ADLs) score were higher at three months following discharge from the hospital in the study group compared with those in the control group. Although applying the discharge instructions lead to significant increase in postoperative ADLs score than those in the control group, yet more than half of the subjects in the study group could not recover their pre- fracture level of ADLs. Conclusion: Applying the discharge instructions on patients with hip fracture was effective in enhancing recovery rate for performing ADLs. Positive but insignificant recovery rate was found in some IADLs. Recommendation: Stress the importance of applying the discharge instructions for patients with hip fracture in order to accelerate their recovery and prevent complications.