The Effective Study Of The Continuous Nursing Intervention On Limb Function Of The Aged Hip Fracture Patients

Objective To develop a continuous nursing intervention which including in-hospital and out-hospital and focusing on functional exercises and psychological support for aged hip fracture patients. To evaluate the effect of the continuous nursing intervention on limb function and activity of daily living.Methods 68 aged hip fracture patients meeting to the criterion were recruited and divided into intervention and control group by cluster randomization. There were no statistic differences in age, gender, education level, marriage status, financial status, operation method, comobidity and days in hospital. Patients of intervention group were given continuous nursing intervention including providing Rehabilitaton handbook for hip fractured patients, specific functional exercises guiding , home visit and telephone consulation for more than three months in addition routine care, while the control group only received routine care. Harris Hip Score, Barthel index and GDS were assessed upon discharge, 1st month after discharge, 3th month after discharge. Analyzed group and operation method as between subject factor, the repeated-measures ANOVA was applied to compare the differences between intervention group and control group.Resultsâ‘ The total score of Harris Hip Score were significantly higher in the intervention group than in the control group at the 1^st month after discharge, as well as the 3^th month after discharge (p<0.05). The results of repeated-measures ANOVA indicated that the patients received total hip tarthroplasty operation shown a better recovery than the patients received internal fixation operation (p<0.001) . There was no significant interactive effect on total score of Harris Hip Score between team and operation(p> 0.05) . The score of pain domain of Harris Hip Score were significantly higher in the intervention group than in the control group at discharge and 3^th month after discharge(p<0.05), however, no statistic difference was evidenced on the pain domain of Harris Hip Score between patients received two different operation methods(p>0. 05). The results of repeated-measures ANOVA showed that the score of function domain of Harris Hip Score in the intervention group were higher obviously compared to the control group at 3^th month after discharge(p<0.05). The patients received total hip arthroplasty operation showed a better recovery of hip function than the patients received internal fixation operation (p<0.001) . The score of ROM domain of Harris Hip Score were significantly higher in the interv ention group than in the control group at discharge, 1^st month after discharge, 3^th month after discharge (p<0.01), yet no statistic difference was found on the ROM domain of Harris Hip Score between patients received two different operation methods(p>0.05). There were no significant interactive effect on pain domain, function domain and ROM domian of Harris Hip Score between team and operation method(p>0.05) .â‘¡The Barthel Index score were significantly higher in the intervention group than in the control group (p<0.001) . The results of repeated-measures ANOVA indicated that the patients received total hip arthroplasty operation shown a better recovery of activities of daily living than the patients received internal fixation operation (p<0.001) . There were significant interactive effect on Barthel Index Score between team and operation(p<0.05) , after discharge, in the intervention group, the patients received internal fixation operation had a better recovery on ADL, however, in the control group, the patients received total hip arthroplasty operation had a better recovery on ADL.â‘¢The score of GDS were significantly higher in the intervention group than in the control group at 3^th month after discharge(p<0.05), The patients received total hip arthroplasty operation showed a lower depression level than the patients received internal fixation operation(p<0.001). There were no significant interactive effect on GDS between team and operation method (p>0.05) .Conclusion The continuous nursing intervention focusing on functional exercises and psychological support could help to promote the hip function, activities of daily living and depression level of aged hip fracture patients. Therefore the continuous nursing intervention is an effective approach in improving the physiology and psychology of aged hip fracture patients.