Browsing by Author "Rocha, Paula"
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- Nurses' perspective on transitional care for older person with hip fracture: a qualitative studyPublication . Rocha, Paula; Lavareda Baixinho, Cristina; Albuquerque, Carlos; Batista, Susana; Henriques, Maria AdrianaBackground The aging process, being associated with a decrease in physical functionality, determines an increased risk of falling and, consequently, a greater risk of associated fractures. Among them, hip fracture often causes functional decline and difficulty returning to the state before the fracture. Objective To analyze nurses' perceptions of the transition process of the older person with hip fractures on returning home. Methods A descriptive, exploratory study of a qualitative nature was developed, based on two focus groups (FGs) with semi-structured interviews with nurses providing care to patients with hip fractures undergoing surgical treatment, whose activity takes place in a hospital context and care primary healthcare units, belonging to a Hospital in the central region of Portugal. Systematic data analysis and respective inductive work were carried out, with support from software Meetpulp®. Results The analysis of the two FGs, with 10 participants, outlines the contours of the problem that influences the personal, organizational and political spheres. Professionals recommend solutions to mitigate obstacles to the transition of care, such as: early involvement and better preparation of family members before discharge, offering greater support to caregivers, improving communication between professionals, creating a telephone support line, highlighting the importance networking and streamlining processes. Conclusion Nurses perceive important problems inherent to the transition process of older person with hip fractures, and the resulting impact on family caregivers and health services. The analysis of these aspects can constitute a basis for the reorganization of health services, in search of the best response to these needs.
- Safety-Promoting Interventions for the Older Person with Hip Fracture on Returning Home: A Protocol for a Systematic ReviewPublication . Rocha, Paula; Baixinho, Cristina Lavareda; Marques, Andréa; Henriques, AdrianaAgeing and physical frailty associated with decrease in muscle and bone mass lead to the older persons’ vulnerability and increased risk of falling. It is estimated that one in every ten falls in this age group results in a fracture, leading to a downward spiral in their health status, causing greater dependence, with a progressive functional decline that makes it difficult to return to their functional and social status prior to the fracture. The aim of this study is to identify the available evidence on the interventions that promote the safety of older people with hip fracture after hospital discharge. A search will be performed in MEDLINE and CINAHL databases. Randomised and controlled studies that focus on functional assessment, performance in activities of daily living, level of concern about falls, risk and prevalence of falls, injuries secondary to falls, re-fracture rate and health-related quality of life in hip fracture patients will be included. Two authors will perform the study selection, data extraction, and quality assessment independently. Any disagreements will be resolved through discussion with a third researcher. Methodological quality of the included trials will be evaluated by the Cochrane risk-of-bias criteria, and the Standards for Reporting Interventions in Controlled Trials.
- Safety-promoting interventions for the older person with hip fracture on returning home: A systematic reviewPublication . Rocha, Paula; Baixinho, Cristina Lavareda; Marques, Andrea; Henriques, Maria AdrianaBackground: Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre- fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge. Objective: To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge. Method: A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias. Results: Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling. Conclusions: In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.