Early Mobility After Fragility Hip Fracture

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Authors
Haslam-Larmer, Lynn
Keyword
Aging , Older adult , Hip fracture , Fragility hip fracture , Mobility , Mixed methods , embedded case study , tdf , com-b , Acute care , Knowledge translation
Abstract
Older adults who experience a fragility hip fracture are at risk of significant loss of functional limitation – up to 60% never regain their baseline level of mobility. Research has shown that in the first days following hip fracture surgery, older adults spend an average of 23 hours of each day, either lying or sitting in bed. Daily prolonged periods of bedrest place this older adult population at risk for serious complications. Evidenced based provincial quality standards do recommend that older adults participate in early mobility activities every day after hip fracture surgery. The primary aim within this research was to develop an understanding of factors that may influence an older adult’s participation in mobility activities after experiencing a fragility hip fracture and while still in the acute care hospital setting. Two separate studies were conducted examining older adults' participation in mobility activities after hip fracture surgery. The studies focused on one hospital postoperative unit within a large tertiary care centre. In Study I, a retrospective chart review, it was shown that although healthcare providers demonstrated utilization of the evidence within provincial recommendations, older adults exhibited limited participation in early mobility activities. The chart review did not identify factors on the unit which may have contributed to the low rates of participation in early mobility activities. In Study II, a convergent design mixed methods approach was utilized to comprehensively describe activities undertaken by this older adult population after surgery. Interviews with healthcare providers and patients offered a detailed description of the barriers and enablers influencing mobility activities' facilitation and participation. Findings from this thesis will help in the development and integration of meaningful and locally specific interventions to encourage an older increased participation in early mobility activities after hip fracture surgery.
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