Influence Of Intervention Scheme Based On The Theory Of Timing It Right On Discharge Readiness Of Elderly Patients With Hip Fracture

Objective:1.Based on the theory of Timing It Right,qualitative research were conducted to understand the real feelings and care needs of elderly patients with hip fracture at different stages of disease,and to summarize the dynamic changes of their needs and quality of life,so as to provide theoretical basis for the establishment of inter vention scheme on discharge readiness.2.To develop an intervention scheme on discharge readiness of elderly patients with hip fracture based on the theory of Timing It Right,and to explore the effect s of the scheme on discharge readiness,recovery of hip joint,daily life activities a bility and quality of life of patients.Method:1.Qualitative research: Based on theory of Timing It Right,47 elderly patients with hip fracture in five stages were investigated through qualitative research to un derstand their real feelings and care needs,and data were analyzed by Colaizzi met hod,providing important reference for the construction of intervention scheme on di scharge readiness in this study.2.Scheme construction: Based on the theory of Timing It Right and combined with preliminary qualitative and literature research,the first draft of intervention sche me was formed,and the final draft of intervention scheme was shaped by two roun ds consultation that includes 18 experts and preliminary experiments.3.Empirical research: A quasi-experimental study was conducted to carry out pr eliminary application of the constructed intervention scheme on discharge readiness for elderly patients with hip fracture.In this study,68 elderly patients with hip frac ture were selected from May 2021 to October 2021 in the department of Orthopaed ics,in a class III A hospital in Shanxi Province.Patients from May 2021 to July 2021 was control group(n=35)and adopted routine nursing measures for elderly whi le patients from August 2021 to October 2021 was intervention group(n=33)and c arried out the intervention scheme based on the theory of Timing It Right construct ed in early stage.The patients’ discharge readiness,recovery of hip joint,the influe nce of daily activity ability and the quality of life of the two groups were compare d.Results:1.Qualitative research resultsThe results of thematic analysis of interviews for elderly patients with hip fracture showed that the care needs of patients in different periods were extracted five themes based on the theory of Timing It Right.The diagnosis period is mainly to understand the disease condition,emotional support,etc.The perioperative period is the initial training of rehabilitation treatment and economic reimbursement,etc.Prepare for the role of primary caregiver and exercise guidance for home rehabilitation during discharge readiness period;The adjustment period included family support and social support and continuous care after discharge.Adaptation period is to return to society and so on.2.Scheme construction resultsBased on literature review and Delphi method,this study constructed a scientific,effective and clinically applicable intervention scheme on discharge readiness for elderly patients with hip fracture,which consists of five different periods: diagnosis period,perioperative period,discharge readiness period,adjustment period and adaptation period,with a total of 54 items.3.Empirical research results(1)The shedding of research objects: In intervention group,37 patients were selected and 4 patients shed,of which 1 patient with severe complications,1 patient refused to follow up and 2 patients missed follow-up due to discharge from hospital.In control group,37 patients were selected and 2 patients shed,1 patient with severe complications and 1 patient missed follow-up due to discharge from hospital.Finally,a total of 68 subjects were included in this study,including 33 in the intervention group and 35 in the control group.(2)Before intervention,the baseline data(including general data,Harris hip function score,Barthel Index score and quality of life score)of the two groups were tested for balance.The difference were comparable and with no statistical significance(P > 0.05).(3)After intervention,the score of discharge readiness of elderly patients with hip fracture in the intervention group were significantly better than those in the control group,and the difference between the two was statistically significant(P<0.001).Patients’ recovery of hip joint and daily life activities ability score in the intervention group were significantly higher than those in control group at discharge,1 month and 3 months after discharge,the difference bewteen the two was statistically significant(P<0.05);The total score and each dimension score of quality of life in the intervention group was significantly better than that in the control group at discharge,1 month and 3 months after discharge,existing statistically significant difference(P<0.05).Conclusion:1.The main care needs of elderly patients with hip fracture show dynamic changes at different stages of the disease and with different emphases.Understand the patients’ care needs in full-cycle,provide timely discharge readiness services for them,promote the continuity of post-discharge treatment and care,and improve the quality of life of patients.2.Based on the theory of Timing It Right,the intervention scheme on discharge readiness for elderly patients with hip fracture is conducive to improve patients’ discharge readiness,recovery of hip joint,daily life activities ability and quality of life,which can provide a reference basis for the discharge readiness of elderly patients with hip fracture.