老年髋部骨折患者从医院及时转至康复机构再到家的路径（PATH4HIP）的可行性、可接受性及初步效果：一项混合方法研究方案

Feasibility, acceptability, and preliminary effects of PATH FOR timely transfer of geriatric HIP fracture patients from hospital to rehabilitation to home (PATH4HIP): a protocol for a mixed method study.

作者信息

Backman Chantal, Harley Anne, Papp Steve, Webber Colleen, Poitras Stéphane, Berdusco Randa, Beaulé Paul E, French-Merkley Veronique

机构信息

School of Nursing, Faculty of Health Sciences, University of Ottawa; Affiliate Investigator, Ottawa Hospital Research Institute, Affiliate Investigator, Bruyère Research Institute, 451, Smyth Road, RGN 3239, Ottawa, ON, K1H 8M5, Canada.

Bruyere Continuing Care; Assistant Professor Faculty of Medicine, University of Ottawa, 43 Bruyère St, Ottawa, ON, K1N 5C8, Canada.

出版信息

Pilot Feasibility Stud. 2022 Jun 11;8(1):124. doi: 10.1186/s40814-022-01079-z.

DOI:10.1186/s40814-022-01079-z

PMID:35690813

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9188093/

Abstract

BACKGROUND

Hip fractures in older adults are significant contributors to severe functional decline and disability as well as hospitalization and increased health care costs. Research shows that timely referral to geriatric rehabilitation leads to better patient outcomes. Currently, a wide variability in the timing, the frequency, and the choice of appropriate setting for rehabilitation of hip fracture patients exists.

AIM

Evaluate the feasibility, acceptability, and preliminary effectiveness of PATH4HIP, a pathway intervention for timely transfer of post-operative geriatric hip fracture patients from hospital to rehabilitation to home.

METHODS

This is a single-arm, pragmatic feasibility study to measure reach, effectiveness, adoption, implementation, and maintenance of PATH4HIP, a pathway for post-operative hip fracture patients from a large academic health science center to a geriatric rehabilitation service in Ottawa, Canada. During a 6-month period, all hip fracture patients, 65 years of age or older who have undergone surgery and have met the eligibility criteria (n = 96), will be transferred to the geriatric rehabilitation service no later than post-operative day 6. Patients (n = 10-12) and clinicians who are working on the orthopedic team (n = 10-12) and on the geriatric rehabilitation service (n = 10-12) will be invited to participate in an interview to share their feedback on the intervention's feasibility and acceptability and to provide suggestions to improve PATH4HIP. Descriptive statistics will be used to summarize results of the quantitative data and content analysis will be used to analyze the qualitative data. The study will be open for recruitment from January to July 2022.

DISCUSSION

If feasible, PATH4HIP will result in the reduction of the post-operative acute care length of stay to less than or equal to 6 days, while having no detrimental effect on rehabilitation outcomes such as functional gains, or discharge destination.

摘要

背景

老年人髋部骨折是导致严重功能衰退、残疾以及住院治疗和医疗保健费用增加的重要因素。研究表明，及时转诊至老年康复机构可带来更好的患者预后。目前，髋部骨折患者康复的时机、频率以及合适康复机构的选择存在很大差异。

目的

评估PATH4HIP的可行性、可接受性和初步有效性，PATH4HIP是一种将老年髋部骨折术后患者从医院及时转运至康复机构再到家的路径干预措施。

方法

这是一项单臂、务实的可行性研究，旨在衡量PATH4HIP的覆盖范围、有效性、采用情况、实施情况和维持情况，PATH4HIP是一条将大型学术健康科学中心的髋部骨折术后患者转运至加拿大渥太华老年康复服务机构的路径。在6个月期间，所有65岁及以上接受手术且符合入选标准的髋部骨折患者（n = 96），将在术后第6天之前被转运至老年康复服务机构。将邀请患者（n = 10 - 12）以及骨科团队（n = 10 - 12）和老年康复服务机构（n = 10 - 12）的临床医生参与访谈，分享他们对干预措施可行性和可接受性的反馈，并提供改进PATH4HIP的建议。描述性统计将用于总结定量数据的结果，内容分析将用于分析定性数据。该研究将于2022年1月至7月开放招募。