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ISRN Nursing  2012 

The Patient's View of Nursing Care after Hip Fracture

DOI: 10.5402/2012/863291

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Abstract:

Background. The pathway for patients with a hip fracture described in this study is a fast track. Many studies have focused on prevention of various complications but, so far, the patient’s view of nursing care has not been highlighted. Aim. The aim of the study is to illuminate the patient’s view on nursing care when treated for a hip fracture. Method. Ten patients were interviewed. A content analysis design was conducted. Findings. From the analysis, four main categories emerged: waiting times; pain/pain relief and mobilisation; attitude/information and sense of security; complications. Conclusion. Patients generally felt satisfied with the nursing provided. The staff created a feeling of security and showed interest and empathy for the patient. However, patients experienced a stressful waiting for surgery, and patients who developed confusion waited more than 24 hours for surgery. Therefore, waiting time must be decreased. Furthermore, patients’ descriptions of a variety of pain problem show, for example, that good collaboration between the nurse and physiotherapist is critical for achieving good pain relief before mobilisation. Nursing staff need to be attentive and should elicit the patient’s feelings through patient-focused communication in order to relieve anxiety about going home. 1. Introduction Traditionally, the focus of outcome measurement for patients with a hip fracture has been on mortality and surgical implant success. Increasing recognition of the need to diversify outcome measurements has led to the creation and use of a number of outcome scales, for example, general quality of life, activities of daily living, mobility and physical performance; and hip-specific [1]. Many studies have focused on early mobilisation and prevention of various complications [2–4] but, so far, the patient’s view of nursing care has not been highlighted. Globally, the number of patients per year with a hip fracture has been forecast to increase from 1.66 million in 1990 to 6.26 million by the year 2050 [5, 6]. The highest incidence is seen in Scandinavian countries [7, 8]. Hip fractures constitute a serious and common health problem among older adults from both the individual and the public health perspectives, due to the age and comorbidities of the affected patients [9–11]. The worldwide cost of hip fracture treatment including rehabilitation is expected to rise from US$ 34,800 billion in 1990 to US$ 131,500 billion in 2050 as the number of older people increases in coming decades [12]. Therefore, different integrated care pathways have been adopted around

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