From the Department of Orthopaedic Surgery, University of South Florida Morsani College of Medicine, Tampa, FL (Dr. Merimee and Dr. Ali), and the Florida Orthopaedic Institute, Tampa, FL (Dr. Downes, Dr. Mullins, Dr. Sajid, and Dr. Mir).
J Am Acad Orthop Surg Glob Res Rev. 2024 Apr 3;8(4). doi: 10.5435/JAAOSGlobal-D-24-00062. eCollection 2024 Apr 1.
This study aims to evaluate health literacy (HL) in geriatric orthopaedic trauma patients and their families as it relates to their post-acute care (PAC) in skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs).
This nonrandomized controlled clinical trial included patients aged 65 years and older treated for acute fracture at a Level 1 trauma center and discharged to either IRF or SNF. First 106 patients enrolled served as the control group and received standard discharge instructions. The second 101 patients were given a set of oral and written instructions regarding PAC detailing important questions to ask upon arrival to their facility.
The mean HL score for all patients/families was 2.4 out of 5. No significant difference was noted in HL scores (2.4 versus 2.3) or median LOS (22 versus 28 days) between the control and intervention groups. Family involvement (68%) slightly improved HL scores (2.6 versus 1.9, P < 0.001). Patients discharged to IRF had better HL scores (3.4 versus 2.3, P < 0.001), shorter LOS (median 15 vs 30 days, P < 0.001), and trended toward improved knowledge of discharge goals (48.1% versus 35.6%) than those in SNF.
System-wide solutions are necessary to improve geriatric HL and optimize outcomes in orthopaedic trauma.
本研究旨在评估老年骨科创伤患者及其家属的健康素养（HL），并探讨其与康复护理机构（SNF）和住院康复机构（IRF）的康复护理之间的关系。
本非随机对照临床试验纳入了在一级创伤中心接受急性骨折治疗并出院至 IRF 或 SNF 的 65 岁及以上患者。前 106 名入组患者作为对照组，接受标准出院指导。第二组 101 名患者则收到了一套关于 PAC 的口头和书面说明，详细说明了到达医疗机构时需要提出的重要问题。
所有患者/家属的 HL 平均得分为 5 分中的 2.4 分。对照组和干预组之间的 HL 得分（2.4 分与 2.3 分）或中位 LOS（22 天与 28 天）无显著差异。家属参与（68%）略微提高了 HL 得分（2.6 分与 1.9 分，P < 0.001）。与 SNF 相比，出院至 IRF 的患者具有更好的 HL 得分（3.4 分与 2.3 分，P < 0.001）、更短的 LOS（中位数 15 天与 30 天，P < 0.001）和出院目标知识改善的趋势（48.1%与 35.6%）。
需要系统范围的解决方案来提高老年骨科 HL，并优化骨科创伤患者的结局。
