Effectiveness of a Rehabilitation Self-Efficacy Program on Postoperative Outcomes in Older Adults with Hip Fracture: A Randomized Controlled Trial

Abstract

Older adults with hip fractures who have undergone surgery require long-term care to relieve pain, improve physical function, and enhance their quality of life. Thus, continuing postoperative care is imperative for quick recovery. This randomized controlled trial examined the effectiveness of a rehabilitation self-efficacy program to enhance postoperative outcomes, including exercise self-efficacy, pain, activities of daily living, strength of muscles, and quality of life. Fifty-eight Thai older adults were randomly assigned to the intervention (n = 29) and control groups (n = 29). The intervention group received the eight-week intervention, while the control group received only usual care. Data were collected through questionnaires, including the Self-Efficacy Quadriceps and Gluteal Exercise Questionnaire, the Numeric Pain Rating Scale, the Modified Barthel Activity of Daily Living Index, and the Mini-Osteoarthritis of Knee and Hip Quality of Life Questionnaire. A hand-held dynamometry was used to assess quadriceps muscle strength. Data were analyzed using descriptive statistics and a two-way multivariate analysis of variance with repeated measures. The results revealed that the intervention group showed significantly higher exercise self-efficacy and activities of daily living, but less pain than the control group at discharge, and 2 and 8 weeks after hospital discharge. The quadriceps muscle strength and quality of life in the intervention group were significantly higher than those in the control group at 8 weeks after hospital discharge. It can be concluded that this program is effective. Nurses should integrate into this program in practice to enhance overall care quality for older adults with hip fractures. However, further testing in various settings is required before the program is widely used.