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Inicio Medicina Clínica (English Edition) Effectiveness of a multidisciplinary educational intervention in patients with h...
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Vol. 153. Issue 12.
Pages 446-453 (December 2019)
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Vol. 153. Issue 12.
Pages 446-453 (December 2019)
Original article
DOI: 10.1016/j.medcle.2019.02.034
Effectiveness of a multidisciplinary educational intervention in patients with hip fracture: SWEET HOME study
Efectividad de una intervención educativa multidisciplinar en pacientes con fractura de fémur: estudio SWEET HOME
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Teresa Sanclemente-Bolia,
Corresponding author
tsanclemente@vhebron.net

Corresponding author.
, Sandra Ponce-Ruiza, Consuelo Álvarez-Lorenzoa, Esperanza Zuriguel-Pérezb, Raquel Tapia-Melenchona, Marc Ramentol-Sintasc, Maria del Mar Villar-Casaresc, Jordi Teixidor-Serraa, Vicente Molero-Garcíaa, Judith Sánchez-Rayad, Pilar Lalueza-Brotoe, Àlex Ginés-Puertasd, Miriam Garrido-Cluab, Jaume Mestre-Torresc
a Servicio de Cirugía Ortopédica y Traumatológica, Hospital Universitari Vall d’Hebron, Barcelona, Spain
b Institut de Recerca Vall d'Hebron (VHIR), Barcelona, Spain
c Servicio de Medicina Interna, Hospital Universitari Vall d’Hebron, Barcelona, Spain
d Servicio de Medicina Física I Rehabilitación, Hospital Universitari Vall d’Hebron, Barcelona, Spain
e Servicio de Farmacia, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Figures (1)
Tables (5)
Table 1. Description of the educational intervention.
Table 2. Descriptive statistics of the results in quantitative variables at the different times of the study.
Table 3. Evaluation of healthcare education (HE) according to the perception of the patient, the caregiver and the professionals.
Table 4. Consolidation of the healthcare education received during hospitalization.
Table 5. Patient and caregiver satisfaction with the entire care process.
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Abstract
Background and Objective

Hip fracture is a common injury among elderly patients. The main goal of our study was to assess the effectiveness of a multidisciplinary educational intervention aimed at hip fracture patients to promote home discharges and reduce in-hospital complications.

Materials and Methods

A quasi-experimental study was performed by taking repeated measurements at hospital admission, at hospital discharge, and at both 30 days and one year of discharge. Patients aged ≥65 years with hip fracture who were admitted to the Orthogeriatric Service between February 2016 and January 2017 were included in the study. The educational intervention consisted in two coordinated actions: patient education administered during their hospitalization and multimodal support provided during their discharge home.

Results

A total of 67 patients were included in the study (77.6% of whom were women aged 84.19±7,78). Of these, 70.1% were discharged home, which doubles the figures recorded in the 2014–2015 period. The rate of readmission at 30 days and one year of the discharge was 8.5%. At the one-year follow-up, the patient’s dependence to perform basic activities of daily living was nearer to the pre-fracture level (Barthel: 86.67±19.31; 94.33±14.66), their mobility had improved in comparison with the time of discharge (Parker: 4.73±1.84; 6.73±2.76; Timed Up and Go Test: 38.29±21.27; 21.91±10.97), and their cognitive function had not worsened significantly. The patient education measures improved the patients’ autonomy as perceived by the patients, the caregivers, and the healthcare providers. Satisfaction with the healthcare received was high.

Conclusions

As a novelty to the already described benefits in orthogeriatric care models, this study would contribute by proving an increase of the number of patients discharged home in a safe condition.

Keywords:
Elderly
Caregiver
Patient education
Femur fracture
Resumen
Antecedentes y objetivo

La fractura de fémur (FF) es una lesión frecuente en personas de edad avanzada. El objetivo fue evaluar la efectividad de una intervención educativa multidisciplinar en pacientes con FF para favorecer el regreso al domicilio y disminuir las complicaciones hospitalarias.

Material y método

Estudio cuasiexperimental con medidas repetidas al ingreso, alta, 30 días y al año de seguimiento. Se incluyeron pacientes ≥ 65 años con FF ingresados en la Unidad de Ortogeriatria entre febrero 2016 y enero 2017. La intervención educativa constó de dos actuaciones coordinadas: una educación sanitaria durante la hospitalización y un soporte multimodal durante la transición al domicilio.

Resultados

Se incluyeron 67 pacientes (77,6% mujeres, edad 84,19±7,78). Regresaron al domicilio el 70,1%, doblando la cifra de los años 2014 -2015. Hubo un 8,5% de reingresos a los 30 días y al año. Al año, el nivel de dependencia fue cercano al nivel prefractura (Barthel: 86,67±19,31; 94,33±14,66), la movilidad mejoró respecto al alta (Parker: 4,73±1,84; 6,73±2,76; Timed Up and Go test: 38,29±21,27; 21,91±10,97) y el rendimiento cognitivo no empeoró de forma significativa. La percepción de pacientes, cuidadores y profesionales fue que la Educación Sanitaria mejoró la autonomía del paciente. La satisfacción con el proceso asistencial fue alta.

Conclusiones

Este estudio aporta como novedad a los beneficios ya descritos en los modelos asistenciales ortogeriátricos, el incremento del número de pacientes que regresan al domicilio en condiciones de seguridad.

Palabras clave:
Anciano
Cuidadores
Educación en salud
Fractura del fémur

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