Hip Fractures
Conditions
Keywords
hip fracture, family caregiving, smart care, person-centered care, precision care
Brief summary
This study aims to 1) develop an Advanced Person-Centered (APC) Smart Home Care Model that is able to predict patient outcomes; and 2) evaluate the effectiveness of this model by assessing improvements in care and recovery for older individuals post hip fracture.
Detailed description
The APC Smart Home Care Model will be developed as follows: a) incorporate a prediction system based on ML data available from our prior studies; b) incorporate an enhanced feedback system using results from the prediction system, which will allow family caregivers to receive timely alerts and facilitate interactions between home care nurses and caregivers; and c) the APC prediction system will be further developed to allow for implementation of targeted home nursing interventions that can be individualized to meet the specific needs of each family caregiver and the person recovering from hip fracture. A mixed-methods approach will be employed to examine the effectiveness of the system, using a combination of quantitative and qualitative data.
Interventions
BEHAVIORALAdvanced Person-Centered (APC) Smart Home Care Model
Enhanced Smart Care Model (SCM) that incorporates precise predictions of adverse outcomes and improvements in the real-time feedback system for caregivers and person-center home-based nursing.
Sponsors
Chang Gung Memorial Hospital
Chang Gung University
National Health Research Institutes, Taiwan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to 120 Years
Healthy volunteers
No
Inclusion criteria
1. ≥ 60 years old, 2. had been transferred from the emergency department to the hospital due to a unilateral hip fracture, 3. repair of the hip fracture involved either hip arthroplasty or internal fixation, 4) their primary place of residence was northern Taiwan
Exclusion criteria
1. severity of cognitive impairment (a CMMSE score of \< 10), 2. known to be terminally ill, 3. has no primary family caregiver, 4. residing in an institutional care facility
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Caregiver preparedness | 1st month following hospital discharge | Caregiver readiness to handle caregiving responsibilities and associated stresses. Score range 0-32, with higher score indicating more prepared. |
| Caregiver Preparedness | 6th month following hospital discharge | Caregiver readiness to handle caregiving responsibilities and associated stresses. Score range 0-32, with higher score indicating more prepared. |
| Fall Incidents. | 1st month following discharge | number of falls |
| Fall insidents | 6th month following hospital discharge | number of falls |
| Fall incidents | 12th month following hospital discharge | Number of falls |
| range of motion | 1st month following hospital discharge | The clinical outcomes to be assessed include range of motion (ROM) in the affected limb in degree |
| Muscle strength of affected limb | 1st month following hosptial discharge | maximum amount of force that a muscle can generate during a single contraction. The unit is weights. |
| Visual analog of Pain score | 1st month following hospital discharge | patient self-report that collected by assessor. Score range 0-100, with higher score indicating more pain. |
| Barthel Index | 1st month following discharge | assessor measures functional indepdencen in activities of daily living (ADLs) of the patient, score range 0-100, higher score indicate more independent. |
| Lawton IADL scale | 1st month following discharge | Instrumental activities of daily living (ADLs) collected by assessor. Score rage from 0 tto 8, with 8 indicating more independent function. |
| Caregiver balance | 1st following hospital discharge | The perception of caregivers regarding their ability to manage conflicting caregiving demands. Score range 1-3, with higher score indicating more balance. |
| Caregiver Balance | 6th month following hospital discharge | The perception of caregivers regarding their ability to manage conflicting caregiving demands. Score range 1-3, with higher score indicating more balance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Health-Related Quality of Life (HRQoL) | 1st month following hospital discharge | Taiwan version of the 36-item Short Form Survey (SF-36). Score range 0-100, with higher score indicating better health outcomes. |
| number of hospital readmission | 1st month following hospital discharge | collected by assessor by asking family members |
| Cognitive function | 1st month following hospital discharge | Cognitive function following hip-fracture surgery will be assessed using the Taiwan version of the Mini Mental State Examination. Score ranges 0-30, with higher score indicating better cognitive function. |
| Depressive symptoms | 1st month following hospital discharge | Patients' depressive symptoms will be evaluated using the 15-item Geriatric Depression Scale, short form (GDS-SF). Score range 0-15, with higher score indicating higher depressive symptoms. |
| Nutritional Status | 1st month following hospital discharge | The 18-item Mini Nutritional Assessment (MNA). Score range 0-30, with higher score indicating better nutritioanl status. |
| number of visits to emergency department | 1st month following hospital discharge | collected by assessor asking family members |
Countries
Taiwan
Contacts
CONTACTYea-Ing Shyu, PhD
CONTACTJersey Liang, PhD
PRINCIPAL_INVESTIGATORYea-Ing Shyu
Chang Gung University
Outcome results
None listed