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To explore the pathway of care for people post hip fracture and define what is important for person-centred recovery.
Qualitative design using interpretive descriptive methodology, guided by the Health Empowerment theoretical framework.
Semi–structured interviews were conducted from March to October 2021, focussed on the lived experience of recovery post hip fracture. Thirteen participants were interviewed. Five people post hip fracture; four advanced practice nurses and four practice nurses. Data were analysed using thematic analysis.
Fragments of hip fracture care was a major theme describing a disconnected pathway following discharge from hospital, and exposed the gap between recommendations for follow up and implementation. Gaps highlighted the need for a key contact clinician to support care coordination, use of individualised care plans, clinical pathways for practice nurses, and follow up post hip fracture.
A disconnected recovery pathway was found from the lived experience of hip fracture. Findings highlight opportunities to develop integrated person-centred models of care that empower patients to self-manage their recovery. Implementation of an empowered coordinated pathway with a shared care approach integrates consistent care across the whole patient journey.
Identified gaps from a fractured recovery formed key components to support a connected care pathway post hip fracture. Linked by the overarching construct of Health Empowerment, policy and practice development embedding a connected pathway within nurse-led models of care should be considered.
Consolidated Criteria for Reporting Qualitative Research.
No Patient or Public Involvement.
This study explored what was important for recovery post-hip fracture. A fragmented recovery pathway was identified that highlighted key components for improvement. Research supports policy and practice development for nurse-led models of care with an empowered approach post hip fracture.
To propose a conceptual model of dignity-centred care for hospitalised older adults using Levine's Conservation Model as a theoretical framework.
A discursive approach.
Data were obtained from an extensive search of five databases and grey literature without date restrictions for information on patient dignity, dignified care for hospitalised older adults and the Levine Conservation Model.
Dignity is a multifaceted concept encompassing an inherent self-worth and self-worth acquired through personal accomplishments and associations. Hospitalised older adults are at risk of dignity erosion due to complex health conditions, poor healthcare professional- patient communication, inadequate health information, loss of autonomy, inadequate privacy, and infrastructural and systemic barriers. Key components of dignified care include respect, autonomy, privacy, effective symptom management, effective communication and active patient involvement in decision-making. The proposed conceptual model integrates Levine's principles of conservation into a dignity-centred care framework. This model identifies threats to dignity in hospitalised older adults and outlines practical interventions to mitigate these threats in order to maintain or restore dignity.
The proposed conceptual model of dignity in care for hospitalised older adults, underpinned by the Levine Conservation Model, offers a practical framework to guide healthcare professionals in providing care that upholds the dignity and well-being of older adults. The model can serve as a foundation for developing institutional policies and training programmes that reflect the multidimensional nature of dignity in care for older adults.
The study addressed both the conceptual ambiguity and skills gap surrounding dignity-centred care for older adults by offering a practical guide for integrating dignity-centred principles into routine clinical practice. The findings hold substantial relevance for healthcare practice, providing a structured, theory-informed model to advance dignity-centred care and protect the dignity of hospitalised older adults.
Not applicable.
To develop a person-centred nurse-led model of care framework to empower people post hip fracture.
Modified e-Delphi study.
A Modified e-Delphi study seeking expert opinion from people with the lived experience of hip fracture and clinicians was implemented. Content experts consisted of 17 nursing and medical clinicians and four people with the experience of hip fracture.
Study found > 70% consensus on all 20 statements rating the importance and feasibility of care components in the Modified e-Delphi survey. Themes developed from content analysis of expert free text responses comprised: Relationships support person-centred care; Value of a Specialist Hip Fracture Nurse; Prioritising is key to positive outcomes. PREPARE—Empowering People Post Hip Fracture: A Conceptual Framework for a nurse-led model of care was developed from study findings, highlighting key principles: person-centred care; evidence-informed practice; Health Empowerment; organisational governance; follow-up and evaluation, constituting this framework.
This study presents PREPARE—Empowering People Post Hip Fracture: A Conceptual Framework for a nurse-led model of care. PREPARE presents a structured approach to empowering people post hip fracture, outlining the aim and context in which the model of care is intended. It highlights an integrated, shared, coordinated approach to the care of people post hip fracture. Shared care empowers people and their support person to effectively manage their recovery journey and safely remain supported in the community.
PREPARE outlines a structured framework to support nurse leaders in implementing nurse-led models of care for people post hip fracture. There is an opportunity to empower nurse leaders and patients to support the recovery journey through education encompassing this person-centred holistic framework.
To our knowledge this is the first study to develop a conceptual framework for a nurse-led model of care to empower people post hip fracture. This model highlights opportunities for an integrated shared, coordinated approach to the care of people post hip fracture. PREPARE—Empowering People Post Hip Fracture: A Conceptual Framework for a nurse-led model of care, offers a structured approach for localised health service development of person-centred nurse-led empowerment models of care.
DELPHISTAR—Delphi studies in social and health sciences—Recommendations for an interdisciplinary standardised reporting.
The experiences of people post-hip fracture, and clinicians were elicited to inform the PREPARE Conceptual Framework.
To examine residential aged care staff's experience of death and grief, and their support needs.
A mixed-methods sequential explanatory design, using an online cross-sectional survey that included the Texas Revised Inventory of Grief and the Grief Support in Health Care Scale. Followed by semi-structured interviews with direct care workers and managers working in residential aged care homes were conducted.
Over 60% of participants experienced five or more resident deaths in the previous 12 months. Although, different levels of grief were experienced among different roles, the importance of open communication and opportunities for farewells after resident death was highlighted. Participants suggested support and education to normalise grief and promote self-care.
Recognising staff grief following the resident death is important. Providing support and education may help improve staff wellbeing and contribute to the delivery of high-quality care for both residents and their families.
Staff grief after a resident death needs to be recognised, and continuing education and support are required for their wellbeing.
The STROBE and SRQR checklists were applied.
No Patient or Public contribution.
To co-develop storyboards and scripts for multimedia resources to support the information needs of informal carers (carers) of older adults from Greek, Italian and Chinese (Cantonese- and Mandarin-speaking) Australian backgrounds during hospital-to-home transitions.
A modified experience-based co-design methodology was used to co-develop four storyboards and scripts with Greek, Italian and Chinese Australian carers and advocates from multicultural community-aged care organisations. To promote relevance, a Carer Advisory Group guided the research. The Carer Advisory Group, comprising 10 people, included carers and advocates from participating multicultural community-aged care organisations, a social worker from a large public health service, and policy representatives. Twenty-nine participants took part from June 2023 to April 2024. Data collection involved two rounds of co-development including 2 workshops, 9 small group interviews and 11 individual interviews. Round 1 focused on understanding participants' experiences of older adult care transitions, information needs and advice for other carers. This information was used to develop categories and example quotes to draft four storyboards reflecting participants' descriptions of the carer and patient journey during care transitions. Round 2 involved draft storyboards being presented to the same participants who advised on their acceptability. Certified interpreters and translators were used throughout data collection.
The co-developed categories, four storyboards and scripts are presented. Participants and the Carer Advisory Group agreed that the findings would be used to develop multimedia resources to support the information needs of carers and older adults from Greek, Italian and Chinese Australian backgrounds in care transitions.
The storyboards and scripts for multimedia resources are expected to improve access to information and services for carers and older adults from culturally and linguistically diverse backgrounds. The storyboards and scripts are examples to guide policymakers and leaders in improving transitional care in Australia and internationally.
The reporting of the study has adhered to the COREQ guidelines.
Informal carers were involved in the Carer Advisory Group which provided guidance and consultation to each phase of the project. Their contributions included reviewing the ethics application prior to submission for ethical review, and reviewing storyboards and scripts to optimise the relevance for informal carers and older adults.
FreshRSS 