title: Changing caring behaviours in rehabilitation after a hip fracture - A tool for empowerment?
abstract: Different rehabilitation programs after surgery have been presented to improve the outcome for patients with a hip fracture. Empowerment has been suggested as useful, but requires a change in the caring behaviours of health professionals. The aim with this study was to evaluate if training and supervision of the nursing staff could alter caring behaviours. A case-control study of nursing staff treating hip fracture patients was performed at a hospital with two sites. Training and supervision was given to the nursing staff at the intervention site. The intervention focused on creating positive care interaction by using eight guidelines. The evaluation was performed with recordings of a constructed caring situation before training, and observations of care situations at the ward before and after intervention. The results showed no differences at baseline between the two sites in the caring behaviours. After intervention, significant effects of caring behaviours were seen in seven out of eight guidelines, the effect sizes ranged from medium to large. The findings indicate that the nursing staff can change caring behaviours and facilitate the empowerment of patients with a hip fracture.
authors.affiliation: a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Lene
authors.initials: L
authors.lastname: Lindberg
authors.affiliation: b Department of Orthopaedics, Section of Orthopaedics and Sports Medicine , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Wilhelmina
authors.initials: W
authors.lastname: Ekström
authors.affiliation: c Department of Orthopaedics, Intervention and Technology (CLINTEC) , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Hedström
authors.affiliation: c Department of Orthopaedics, Intervention and Technology (CLINTEC) , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Flodin
authors.affiliation: d Department of Learning, Informatics, Management and Ethics (LIME) Medical Management Center , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Löfgren
authors.affiliation: d Department of Learning, Informatics, Management and Ethics (LIME) Medical Management Center , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Leif
authors.initials: L
authors.lastname: Ryd
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000592:standards*; D016530:Orthopedic Nursing / Q000592:standards*; D011209:Power, Psychological; D017410:Practice Guidelines as Topic / Q000592:standards*
keywords: Empowerment; caring behaviour; hip fracture; observations; supervision; training