title: The SICAM-trial: evaluating the effect of spouses' involvement through case management in older patients' fast-track programmes during and after total hip replacement.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect of spouses' involvement in older patients' care trajectories, using case management as intervention in total hip replacement through fast-track programmes.
  
  
  BACKGROUND
  Patients need their spouses to be involved in their fast-track programmes and this involvement is often associated with improvements in patient outcomes. However, the effect of spouses' involvement in older patients' fast-track programmes has not yet been investigated.
  
  
  METHODS
  A two-group quasi-experimental design with pre-test and repeated post-test measures was conducted in an orthopaedic ward of a Danish Regional Hospital from February 2014-June 2015. Spouse-patient dyads were initially recruited for the control group (n = 14), receiving usual care; dyads for the intervention group (n = 15) were recruited afterwards, receiving case management intervention elements before, during and after admission.
  
  
  METHODS
  Face-to-face interviews on questionnaires were conducted with spouses and patients at baseline, 2 weeks and 3 months after discharge, measuring spouses' caregiver satisfaction, difficulties and level of anxiety and patients' functional and nutritional status, pain and level of depression.
  
  
  RESULTS
  The results showed that there were no differences between the groups with regard to any of the outcome measures. However, statistically significant improvements were found in the patient groups on functional status, pain and depression and in the groups of spouses on caregiver satisfaction.
  
  
  CONCLUSIONS
  The case management intervention seemed to have an effect in patient and spousal groups; however, this improvement could also have been caused by the effect of fast-track treatment.
authors.affiliation: Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark.|Section of Nursing, Aarhus University, Copenhagen, Denmark.
authors.forename: Connie Bøttcher
authors.identifier: http://orcid.org/0000-0003-3158-3301
authors.initials: CB
authors.lastname: Berthelsen
authors.affiliation: Department of Health Sciences, Lund University, Sweden.|Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
authors.forename: Jimmie
authors.initials: J
authors.lastname: Kristensson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D017028:Caregivers / Q000523:psychology*; D019090:Case Management; D003718:Denmark; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: case management; complex intervention; fast-track programme; nursing; older patients; quasi-experimental; spouses; total hip replacement