Clinically relevant behaviors in elderly hip fracture inpatients.
OBJECTIVE
To examine the range of behaviors documented by inpatient rehabilitation staff and the association of these behaviors with functional outcome, in elderly persons undergoing rehabilitation after hip fracture.


METHODS
Subjects were 137 patients, aged 60 and older, admitted to a rehabilitation hospital after a hip fracture, defined as having either a good or poor rehabilitation outcome based on change in Functional Independence Measure motor subscale scores during the course of their admission. Their charts were systematically reviewed for nursing and therapy staff documentation of behaviors. Prevalence of behaviors was compared between good and poor rehabilitation outcome group.


RESULTS
Disturbances in cognition and rehabilitation participation were common and were associated with poorer rehabilitation outcome. Behaviors reflective of depression and anxiety were relatively uncommon and not associated with rehabilitation outcome.


CONCLUSIONS
Rehabilitation staff frequently detect and document disturbances in cognition and participation that are associated with poorer rehabilitation outcome. It is recommended that staff observations be routinely added to mental health evaluations. Additionally, routine mental health screening and required staff documentation of behaviors would improve case detection rate.
Dorra
Helen H
HH
University of Pittsburgh School of Medicine, USA.
Lenze
Eric J
EJ
Kim
Yookyung
Y
Mulsant
Benoit H
BH
Munin
Michael C
MC
Dew
Mary Amanda
MA
Reynolds
Charles F
CF
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003072:Cognition Disorders / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005163:Factor Analysis, Statistical; D005260:Female; D015438:Health Behavior; D006620:Hip Fractures / Q000534:rehabilitation*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016896:Treatment Outcome