Self-care Enhancement Program for Geriatric Hip Fracture Patients in Princess Margaret Hospital

Abstract Description

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Authors (including presenting author) :

Yeung LH(1), Law WY(1), Ngan LY(1), Tang WY(1), Lee KL(1), Wan YH(1), Chan SY(1), Cheng WC(1), Wong YC(1), Choi SH(2), Wong MH(3)

Affiliation :

(1)Occupational Therapy Department, (2)Department of Orthopaedics and Traumatology, (3)Department of Surgery

Introduction :

Geriatric hip fracture often results in disability and reduced quality of life. Incidence of hip fracture increases exponentially with age. With the fast-growing elderly population, it becomes a foreseeable concern to the medical system. Self-care Enhancement Program (SEP) is a newly developed Occupational Therapy program for geriatric hip fracture patients in Princess Margaret Hospital. It has been implemented in Mixed Surgical Ward since March 2018. There are three major components in SEP: A signage system is set up at bedside to indicate the self-care performance of patients and encourage their participation in activities of daily living (ADL); an educational booklet is designed to improve patients’ understanding on hip fracture and precautions after hip surgery; early care-giver training is arranged to improve caring techniques.

Objectives :

This program aims at (1) enhancing functional outcome after hip fracture; (2) improving patients’ self-efficacy in handling ADL; (3) promoting early participation of care-givers in assisting patients’ ADL.

Methodology :

A case series study design was employed. Paired t-test was used to examine the difference in pre- and post-test ADL performance. Pearson’s correlation was used to investigate the relationship between functional outcome and cognitive function. Outcome measures: ADL performance was measured by Modified Barthel Index (MBI), cognitive function was measured by Hong Kong version of Montreal Cognitive Assessment (5-minute Protocol), self-efficacy and satisfaction of patients and care-givers were measured by self-reported 10-point scale.

Result & Outcome :

From March to September 2018, 127 patients aged 65-102 participated in SEP. There was significant improvement in MBI score after SEP (p< 0.05), mean MBI score increased from 38.7 to 47.2. Cognitive function was positively correlated with functional outcome (p< 0.05). Patient’s self-efficacy in handling ADL increased by 40% (from 2.15 to 6.07) and care-giver’s self-efficacy in assisting patient’s ADL increased by almost 50% (from 1.94 to 6.39). Patients and care-givers were highly satisfied with SEP, with mean satisfaction score of 8.4/10 and 8.7/10. Conclusions: Patients showed improvement in functional performance after participating in SEP. Those with better cognitive function were associated with better functional outcome. SEP can also improve self-efficacy of patients and care-givers in handling ADL or providing care in ADL.