Department of Nutrition and Dietetics, Flinders University, 5001 Adelaide, Australia.
J Rehabil Med. 2013 Jan;45(1):81-6. doi: 10.2340/16501977-1054.
To investigate the preferences of frail older people for individualised multidisciplinary rehabilitation to promote recovery from a hip fracture.
Discrete Choice Experiment.
Acute and Rehabilitation Hospitals in Adelaide, South Australia.
Eighty-seven patients with recent hip fracture (16 living in residential care facilities prior to fracture).
Patients providing informed consent (or consenting family carer proxies in cases where patients were unable to provide informed consent (n = 10)) participated in a face to face interview following surgery to repair a fractured hip to assess their preferences for different configurations of rehabilitation programs.
Overall, participants expressed a strong preference for improvements in mobility and a willingness to participate in rehabilitation programs involving moderate pain and effort. However, negative preferences were observed for extremely painful interventions involving high levels of effort (2 h per day for 2 months). Subgroup analysis revealed consistently similar preferences according to place of residence (residential care vs community).
Improvements in mobility are highly valued by frail older people recovering from hip fracture, including those living in residential care. Further research should be directed towards achieving greater equity in access to rehabilitation services for the wide spectrum of patients attending hospital with hip fractures.
调查虚弱老年人对个体化多学科康复的偏好，以促进髋部骨折康复。
离散选择实验。
南澳大利亚阿德莱德的急性病医院和康复医院。
87 名近期髋部骨折患者（骨折前有 16 名居住在养老院）。
接受手术修复髋部骨折的患者（或无法提供知情同意的患者的同意家属代理）在手术后参与了面对面的访谈，以评估他们对不同康复方案配置的偏好。
总体而言，参与者对改善活动能力表示出强烈的偏好，并愿意参加涉及中度疼痛和努力的康复计划。然而，他们对需要高度努力（每天 2 小时，持续 2 个月）和极其疼痛的干预措施表示出负面偏好。亚组分析显示，根据居住地点（养老院与社区），偏好始终相似。
髋部骨折康复的虚弱老年人，包括居住在养老院的老年人，非常重视活动能力的改善。应进一步研究如何在接受髋部骨折住院治疗的广泛患者中实现更公平地获得康复服务。
