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People living in nursing care facilities who are ambulant and fracture their hips: description of usual care and an alternative rehabilitation pathway

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العنوان: People living in nursing care facilities who are ambulant and fracture their hips: description of usual care and an alternative rehabilitation pathway
المؤلفون: Susan Kurrle, Rhiannon Crane, Ian D. Cameron, Maggie Killington, Naomi Pratt, Kylie Mills, Arabella McInnes, Owen Davies, Maria Crotty
المصدر: BMC Geriatrics
BMC Geriatrics, Vol 20, Iss 1, Pp 1-11 (2020)
سنة النشر: 2019
مصطلحات موضوعية: medicine.medical_specialty, Dietetics, medicine.medical_treatment, Arthroplasty, Replacement, Hip, Population, lcsh:Geriatrics, Hip fracture, General practitioner, 03 medical and health sciences, Nursing care, 0302 clinical medicine, Intervention (counseling), Activities of Daily Living, Medicine, Humans, 030212 general & internal medicine, Aged care, education, Aged, Aged, 80 and over, education.field_of_study, Rehabilitation, business.industry, Hip Fractures, Nursing home, Usual care, Attendance, Australia, medicine.disease, Exercise Therapy, Nursing Homes, Clinical trial, Long-term care, lcsh:RC952-954.6, Nursing care facility (NCF), Physical therapy, Quality of Life, Accidental Falls, Falls, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, New Zealand, Research Article
الوصف: Background Little is known about treatment provided to people living in nursing care facilities (NCFs) after hospital admission for hip fracture. In addition, there are no clinical guidelines for rehabilitation and recovery following hip fracture for nursing home residents. Methods As part of a randomised trial (SACRED trial), which investigated the efficacy of a four week in-reach rehabilitation program, data were collected which described routine care for 240 people living in 76 nursing care facilities in South Australia who fractured their hips. The in-reach rehabilitation provided to 119 intervention participants is described, including intensity, type and methods used to encourage participation in rehabilitation. Adverse events that occurred, in particular falls, are also reported. Results NCF records indicated that, over the four weeks following discharge from hospital after hip fracture, 76% of patients receiving usual care had a consultation with their general practitioner. Physiotherapy was provided to 79% of patients in usual care (median of 1.96 h over the 4 weeks, which is less than 30 min each week of physiotherapy). In-reach rehabilitation was provided by the hospital team for 13 h over the 4 weeks with almost full attendance at physiotherapy sessions (median of 1 missed session, range 0–7 with a median of 14 physiotherapy sessions attended by participants, range 1–18). Experienced therapists provided a flexible approach to the rehabilitation to account for patients’ dementia and associated neuropsychiatric symptoms while providing dietetic support, mobility training and education to nursing home staff. The number of falls experienced by those in the intervention group was higher compared to those in usual care (Relative Risk 1.38 (95%CI 1.04–1.84, p = 0.03). Conclusions Rehabilitation can be provided to people living in NCFs following hip fracture, even when they have moderate to severe dementia but the model needs to be flexible. Provision of rehabilitation may increase the rate of falls in this population. Further studies are required to establish the feasibility of the intervention in other long term care settings. (327 words). Trial registration ACTRN12612000112864 registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR).
تدمد: 1471-2318
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b9adac0675fc744ff1542a3c3f4a7e97
https://pubmed.ncbi.nlm.nih.gov/32272888
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....b9adac0675fc744ff1542a3c3f4a7e97
قاعدة البيانات: OpenAIRE
الوصف
تدمد:14712318