Authors (including presenting author) :
Shum ST(1), Lam YH(1), Tsang PL(1), Cheng P(1), Lam PL(1)
Affiliation :
(1) Department of Physiotherapy, Queen Mary Hospital
Introduction :
Fracture hip is one of the most common fragility fractures in elderly that requires hospitalization. Early engagement of caregivers was one of the highest endorsed care processes in the recovery of patients. Queen Mary Hospital (QMH) established geriatric fracture hip cubicles (GFHC) in the orthopedic wards in August 2019. The Department of Physiotherapy has conducted a pilot program to engage caregivers in these cubicles at a very early phase in order to facilitate patients’ rehabilitation.
Objectives :
To evaluate the effectiveness of this pilot program on improving patients’ rehabilitation outcomes.
Methodology :
In the GFHC, caregivers and patients were given videos upon admission on patients’ journey prepared by multidiscipline aiming to improve their understanding on the rehabilitation process and compliance to exercise program. During the admission period, caregivers were invited to attend a 30 minutes individual training session conducted by physiotherapist. The training includes the techniques to assist patients to perform exercise, transfer and ambulation. Caregivers’ skills were assessed by physiotherapist with real time feedback. They were encouraged to perform the exercise with the patients during flexible visiting hours.
The mobility difference of patients whose caregivers received training between upon discharge and post-operation day 1 using elderly mobility scale (EMS) and the total length of stay (TLOS) from acute to rehabilitation hospital were compared to matched patients who were not in the GFHC where no caregiver training was provided.
The results of experience questionnaires which were filled by the caregivers after the training and exercise compliance were also evaluated.
Result & Outcome :
From 19 Aug 2019 to 30 Nov 2019, 13 caregivers received the training (due to the COVID-19 pandemic, further data collection was not feasible). The mobility of patients in the GFHC group showed significantly more improvement (p=0.008) upon discharge from QMH than those without training. The TLOS were shortened by 4 days though statistically insignificant.
The experience questionnaire reflected that the caregivers were highly satisfied with the program. They expressed that they were more confident to deliver the exercise with patients after the training. The exercise compliance was 100%.
To conclude, this pilot program showed that early caregiver engagement is an essential component of rehabilitation in geriatric patients with hip fracture. With the development of Allied Health rehabilitation apps, even better outcomes were expected.
