title: The relationship between multidisciplinary discharge outcomes and functional status after total hip replacement.
abstract: OBJECTIVE
  To determine changes in functional status after primary total hip replacement and to explore the relationship between functional status and pain and mobility at time of hospital discharge.
  
  
  METHODS
  Descriptive correlational with a prospective cohort.
  
  
  METHODS
  21 elective primary total hip arthroplasty patients, ages 40 to 78, in an academic health center.
  
  
  METHODS
  Subjects' functional status was measured using the Sickness Impact Profile and the hip outcome tool (Revised Hip Type Specification Tool 13.1), completed by face-to-face interview approximately 2 weeks prior to hospitalization. Pain and mobility were assessed at time of discharge, and the functional status measures were repeated at 3 months after hospital discharge by mail.
  
  
  RESULTS
  Statistically significant changes were found for physical and psychosocial dimensions of functional status, using the Sickness Impact Profile and the hip outcome tool, between the preoperative and postoperative measures. A significant relationship between mobility and pain at the time of discharge and functional status was not established.
  
  
  CONCLUSIONS
  Hospital discharge criteria related to pain and mobility should be used with caution. In addition to pain and mobility information, patient education should reflect knowledge of what can be expected by 3 months postsurgery, including expected and potential improvements in mobility, pain, and ambulation and in nonphysical dimensions, such as sleep, home management, and social interaction. Case management and discharge planning should reflect the wide variance in pain and mobility across patients at time of discharge and the expected gains in specific aspects of functional status after discharge. Research attention should be increased on the identification and application of specific discharge criteria such as pain and mobility levels, and the further development and refinement of nursing-sensitive and practical functional status outcome measures.
authors.affiliation: School of Nursing, University of Virginia, Charlottesville, USA. Richard.Ridge@vtmednet.org
authors.forename: R A
authors.initials: RA
authors.lastname: Ridge
authors.forename: A S
authors.initials: AS
authors.lastname: Goodson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010149:Postoperative Pain / Q000209:etiology*; D010348:Patient Care Team / Q000458:organization & administration*; D010351:Patient Discharge / Q000592:standards*; D011446:Prospective Studies; D018434:Sickness Impact Profile