| Objectives: The purpose of this study is to identify the preoperative needs of the elderly patients with hip fractures and to explore the psychological status and influencing factors of the patients,in order to provide scientific basis for the clinical scientific assessment of patients' needs and the satisfaction of psychological needs of the patients,and provide targeted nursing measures and recommendations for patient rehabilitation.Methods: This study used a cross-sectional design.The convenient sampling method was used to collect 218 elderly hip fracture patients undergoing surgical treatment in two three-grade hospitals in Yan'an from February to December 2017.In this study,General Information Questionnaire,Elderly Hip Fracture Patients' Demand Scale,State Anxiety Inventory(S-AI)and Self-rating Depression Scale(SDS)were used to collect data including the general data,the requirement of preoperative nursing needs,anxiety and depression status of the elderly hip fracture patients.Epi-Data3.0 software was used to input data.After verification,all the data were analysed through SPSS19.0 software.According to data types and characteristics,data were statistically described by mean and standard deviation,and were statistically inferred by t test,ANOVA and correlation analysis.Results:1.General characteristics of the study participants: This study included 218 subjects,including 87 males(39.90%)and 131 females(60.10%).The average age was(73.35 ± 12.08)years old.The subjects were mainly Han(99.10%)and married(83.03%).Most(89.91%)of the patients have an educational background of primary school,lower and junior high school.About half(45.87%)of the research subjects came from rural areas,and 77.62% of the respondents had an average monthly income of less than 3000 yuan.86.6% of the research subjects had health insurance for residents or workers.A total of 207 subjects were living with family members,accounting for 94.95% of the total,and about 97.71% of the subjects were taken care of by family members,relatives,or friends;nearly 3/4 of the patients had other chronic complications.About 143(65.60%)of the patients' fractures were femoral trochanter fracture.Most of the causes of the fracture were fall(88.53%),and more than half of the the patients considered that their knowledge of the disease was lacking(58.26%).2.Preoperative care needs of elderly patients with hip fractures: The average score of the important degree of preoperative nursing needs of the elderly patients with hip fracture was(107.76 ±12.17).The factors affecting the preoperative nursing needs of the elderly patients with hip fractures were marital status(P=0.022),average monthly income(P=0.003),living mode(P=0.016),and the caregivers(P=0.041).All the differences were statistically significant(P < 0.05).The total average score of preoperative nursing demand in elderly hip fracture patients was(102.01 ± 14.60).The factors affecting the satisfaction of the elderly patients with hip fracture before operation were degree of education(P=0.047),average monthly income(P=0.047),and knowledge of disease(P=0.041).All the differences were statistically significant(P < 0.05).3.Anxiety level and influencing factors in elderly patients with hip fracture: The average score of the State Anxiety Scale(S-AI)of elderly hip fracture patients was(44.65 ± 10.11),indicating that the level of preoperative anxiety in elderly hip fracture patients was mild.The factors affecting depression level in elderly hip fractures included age(P=0.006),educational level(P<0.001),occupation(P<0.001),average monthly income(P<0.001),insurance type(P<0.001),and knowledge of disease(P=0.003).All the differences were statistically significant(P < 0.01).4.Depression level and influencing factors in elderly patients with hip fracture: The average score of the Self-rating Depression Scale(SDS)of hip fracture patients was(44.26 ±9.65),indicating that the level of preoperative depression in elderly hip fracture patients was mild.The factors affecting depression in elderly hip fractures included age(P<0.001),educational level(P<0.001),occupation(P<0.001),average monthly income(P<0.001),residence(P=0.033),insurance type(P<0.001),disease diagnosis(P=0.047)and knowledge of disease(P=0.004).All the differences were statistically significant(P < 0.05).5.The relationships between anxiety,depression and preoperative needs in elderly patients with hip fracture: There was a positive correlation(r=0.820,P<0.001)between total score of SDS and total score of S-AI among elderly patients with hip fracture;the total score of SDS had a negative correlation(r=-0.383,P<0.001)with the degree of pre operation demand satisfaction,and the total score of S-AI had a negative correlation(r=-0.438,P<0.001)with the degree of pre-operation demand satisfaction,and the degree of pre-operation demand was positively correlated with the importance of pre-operation demand(r=0.465,P<0.001).The differences were statistically significant(P < 0.001).Conclusions:1.The elderly patients with hip fracture had a high degree of attention to the preoperative needs.The factors that affected the preoperative needs of the patients include the marital status,the average monthly income,the way of living and the caregivers.The elderly hip fracture patients were satisfied with their preoperative needs.The factors that affected the preoperative satisfaction of the patients included the degree of the patient's education,the average monthly income,and the knowledge level of disease.2.The elderly patients with hip fracture had a mild to moderate level of anxiety.The factors that affected the anxiety level of patients included age,educational level,occupation,average monthly income,type of insurance and the knowledge level of disease.Patients with older age,lower level of education,retired,having a resident medical insurance and had lower knowledge level had a higher level of anxiety.3.The elderly patients with hip fracture had a mild level of depression.The factors that affected the depression level of the elderly hip fracture included age,the education level,the occupation,the average monthly income,the residence,the type of insurance,the diagnosis of the disease and the knowledge level of the disease.Patients with old age,low education level,were retired,low income level,living in rural areas,had resident medical insurance and little knowledge about diseases had a higher level of depression.4.The degree of pre-operation demand satisfaction was negatively correlated with depression and anxiety level,the higher the patient's pre-operation demand satisfaction was,the lower the level of depression and anxiety;the degree of pre-operation demand satisfaction was positively correlated with the importance of pre-operation demand,the higher the pre-operative attention was,the higher the degree of patients satisfaction.The depression level and anxiety level of the elderly hip fracture patients were positively related.The higher level of depression,the higher level of anxiety the patients had. |
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