The Effects of a Digitally Enhanced Nursing Discharge Teaching Program on Post-Injury Symptoms in Older Adults With Limb Fractures: A Quasi-Experimental Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 90
- 试验地点
- 2
- 主要终点
- The Berg Balance Scale
研究概览
简要总结
This quasi-experimental study evaluates the effectiveness of a digitally enhanced nursing discharge teaching program for older adults recovering from limb fractures. As patients transition from the acute trauma ward to home care, they often face significant challenges managing pain, psychological distress, and daily functioning. This study compares a structured, digitally supported educational intervention against standard hospital discharge care. The primary goal is to determine if the digital program improves patients' pain intensity, depressive symptoms, and overall quality of life during the first six weeks post-discharge compared to routine care.
详细描述
Geriatric trauma patients, specifically those suffering from limb fractures, experience a high risk of poor functional and psychological outcomes following hospital discharge. Standard discharge teaching is often constrained by the fast-paced nature of acute trauma wards, limiting patients' ability to retain critical recovery information. To address this, the current study implemented a digitally enhanced nursing discharge teaching program.
This study utilized a non-randomized, quasi-experimental design with two parallel arms: a contrast group receiving standard routine discharge care, and an experimental group receiving the digitally enhanced program. The digital intervention included interactive, multimedia educational content delivered prior to discharge, supplemented by structured telephone follow-ups by nursing staff to reinforce symptom management, mobility safety, and recovery strategies at home.
Participants were recruited continuously based on acute hospital admissions. The primary outcomes assessed were pain intensity (Numeric Pain Rating Scale), depressive symptoms (Geriatric Depression Scale-Short Form), and overall quality of life (WHOQOL). Data were collected at three distinct time points: baseline (prior to hospital discharge), two weeks post-discharge, and six weeks post-discharge. The study aims to evaluate the clinical efficacy of this digital transition model and its feasibility for integration into routine geriatric trauma care.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 74 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •First-time patients with limb fracture as the primary diagnosis.
- •Capable of independent mobility before the injury.
- •Able to communicate in Mandarin.
- •Willing to participate from hospital discharge to six weeks post-discharge.
- •Able to use a smartphone and have internet access.
- •A pain score greater than four on the Numeric Pain Rating Scale (NPRS).
- •A depression score greater than four on the Geriatric Depression Scale Short Form (GDS-SF).
排除标准
- •Were cognitively impaired.
- •Suffered from cardiovascular, pulmonary, or cerebral insufficiency.
- •Had a history of psychiatric or terminal illnesses.
- •Had visual impairments.
研究组 & 干预措施
Contrast group
Participants in this contrast arm receive a standard pamphlet, routine hospital discharge care and standard verbal education prior to transitioning home.
结局指标
主要结局
The Berg Balance Scale
时间窗: at 1 months after hospital discharge
The BBS is a 14-item scale used to assess balance of the older adult in various clinical settings. Each item of the BBS is scored from 0 to 4, which are added to make a total score from 0 to 56; a higher score indicates better balance.
The Numeric Pain Rating Scale
时间窗: at 1 months after hospital discharge
The NPRS is a one-dimensional measure of pain intensity in adults. A NPRS has similar anchors at the extremes but offers numbers from 0 through 10. It is well known and broadly used scale in clinical settings. No further reliability and validity tests are needed.
The Geriatric Depression Scale Short Form
时间窗: at 1 months after hospital discharge
The GDS-SF is a 15-item scale used to identify depression in older adults. It is from the original GDS developed by Sheikh and Yesavage to examine the self-perceived emotions of older adults. The version will be used in this study is a validated Chinese that has been tested its reliability in geriatric older population in Taiwan. The GDS-SF features binary scores for a total score of 0-15. A higher score indicates a more severe of depression. In the GDS-SF, a score of 0 to 5 is normal, a score \> 5 suggests depression, and a score ≥ 10 is almost indicative of depression. The Cronbach's alpha for this study will be retested.
The World Health Organization Quality of Life Questionnaire
时间窗: at 1 months after hospital discharge
The WHOQoOL-BREF will be used to measure quality of life. Six popular generic instruments of HRQOL are commonly used as disability outcome measures, some of them were developed later were tested trans-culturally in extensive research programs such as the WHOQoL-BREF. The WHOQoL-BREF is a 26-item scale that is measure along with four subscales including physical, psychological, social relationship and environment domains. Scores range from 1 to 5 with higher scores indicating higher quality of life. The reliability and validity of the Chinese WHOQoL-BREF have been tested in patients with traumatic injuries, but not in geriatric trauma. Thus, the Cronbach's alpha for this study will be retested.
The key body points that match the items in the Berg Balance Scale
时间窗: at 1 months after hospital discharge
Although the BBS has been widely used and has good psychometric properties, the scale has its limitation in detecting detailed change of balance in older adults. Neuls et al. suggested that clinicians could use the BBS combined with other measures considering unique patient factors to quantify the chances of older adults. Therefore, the key points for 17 human parts and body joints matching the 14 items of the BBS will be recorded as images. Video captured by front and side cameras will be made by each item with 5 levels. Because of page limits, we present 7 items to demonstrate how those key points compared to BBS items captured by cameras.
次要结局
未报告次要终点