Lin Pi-Chu, Wang Ching-Hui, Chen Chyang-Shiong, Liao Li-Ping, Kao Shu-Fen, Wu Heng-Fei
Department of Nursing, College of Nursing, Taipei Medical University, Taipei Medical University Hospital, Taipei, Taiwan.
J Clin Nurs. 2009 Jun;18(11):1632-9. doi: 10.1111/j.1365-2702.2008.02695.x.
This study aimed to evaluate the effectiveness of a comprehensive discharge-planning service for hip fracture patients, including length of stay, functional status, self-care knowledge and quality of life (QOL).
Hip fractures are the most devastating result of osteoporosis. Care of these patients from the moment they enter the hospital until discharge and postdischarge is a challenging task, requiring a coordinated approach by an interdisciplinary team.
An experimental design was used. Methods. Fifty hip fracture patients were recruited from a medical centre in Taipei, Taiwan and randomly divided into two groups. The control group received routine discharge nursing care and the experimental group received comprehensive discharge planning. After patient admission, researchers assessed discharge-planning needs, provided discharge nursing instruction, coordinated services and determined discharge placement based on assessment results.
(i) Mean age of 50 hip fracture patients was 78.75 (SD 6.99) years. Mean length of stay was 6.04 (SD 2.41) days for the experimental group and 6.29 (SD 2.17) for the control group. Difference between groups was not significant (t = -0.394, p = 0.696). (ii) The self-care knowledge of the experimental group was higher than that of the control group (F = 11.569, p = 0.001). (iii) Significant improvements were observed in functional status of both groups at three months postdischarge, with no significant differences observed between groups. However, the functional status of experimental group patients showed a slightly better trend than that of the control group. (iv) At three months postdischarge, QOL of experimental group patients was better than control group patients.
A comprehensive discharge-planning service can improve hip fracture patients' self-care knowledge and QOL.
Results of this study can be used clinically as a basis for practical implementation of discharge-planning services in fracture patients.
本研究旨在评估一项针对髋部骨折患者的综合出院计划服务的效果，包括住院时间、功能状况、自我护理知识和生活质量（QOL）。
髋部骨折是骨质疏松最严重的后果。从这些患者入院到出院及出院后的护理是一项具有挑战性的任务，需要跨学科团队采取协调一致的方法。
采用实验设计。方法。从台湾台北的一家医疗中心招募了50名髋部骨折患者，并随机分为两组。对照组接受常规出院护理，实验组接受综合出院计划。患者入院后，研究人员评估出院计划需求，提供出院护理指导，协调服务，并根据评估结果确定出院安置。
（i）50名髋部骨折患者的平均年龄为78.75（标准差6.99）岁。实验组的平均住院时间为6.04（标准差2.41）天，对照组为6.29（标准差2.17）天。两组之间的差异不显著（t = -0.394，p = 0.696）。（ii）实验组的自我护理知识高于对照组（F = 11.569，p = 0.001）。（iii）出院后三个月，两组的功能状况均有显著改善，两组之间无显著差异。然而，实验组患者的功能状况比对照组略好。（iv）出院后三个月，实验组患者的生活质量优于对照组患者。
综合出院计划服务可以提高髋部骨折患者的自我护理知识和生活质量。
本研究结果可在临床上用作骨折患者出院计划服务实际实施的基础。
