Discharge transition experienced by older Korean women after hip fracture surgery: a qualitative study

Abstract

Background This study aimed to explore older Korean women’s discharge transition experiences after hip fracture surgery. Methods This was a descriptive qualitative study. Face-to-face interviews following hip fracture surgery were conducted on 12 women aged 65–87 years. Data were collected 1 to 2 days before discharge and again 4 weeks after discharge following hip fracture surgery, and were analyzed using qualitative content analysis. Results Four main themes were identified: (1) challenge of discharge transition: unprepared discharge, transfer into other care settings, and eagerness for recovery; (2) physical and psychological distress against recovery: frail physical state and psychological difficulties; (3) dependent compliance: absolute trust in healthcare providers, indispensable support from the family, and passive participation in care; and (4) walking for things they took for granted: hope of walking and poor walking ability. Conclusions After their hip fracture surgeries, older women hoped to be able to walk and perform simple daily chores they previously took for granted. Considering the physical and psychological frailty of older women undergoing hip surgery, systematic nursing interventions including collaboration and coordination with other healthcare professionals and settings are necessary to ensure the quality of continuous care during their post-surgery discharge transition. Encouraging partial weight bearing and initiating intervention to reduce fear of falling at the earliest possible time are essential to attain a stable discharge transition. Additionally, older women should be invited to participate in their care, and family involvement should be encouraged during the discharge transition period in South Korea.

Discharge Transition Experience for Lumbar Fusion Patients: A Qualitative Study

“…Similar to studies indicating reduced appetite and functional impairment in elderly surgery patients, postoperative tiredness and discomfort might make it difficult to undertake prescribed activities. 13,16,21 The importance of more research on fragility and postoperative recovery in elderly surgery patients is underlined.…”

“…For healthcare personnel, patients, and their families, discharge is a complex and difficult process 14. To guarantee the ongoing quality of care throughout the postoperative discharge transition, systemic nursing interventions and clear communication, including collaboration and coordination with other healthcare professionals and the community, are necessary 13,15…”

“…6,11 Despite being aware of the preoperative lumbar fusion treatment plan, the participants were not ready for release and were unhappy because they anticipated the discharge would be early. 12,13 For healthcare personnel, patients, and their families, discharge is a complex and difficult process. 14 To guarantee the ongoing quality of care throughout the postoperative discharge transition, systemic nursing interventions and clear communication, including collaboration and coordination with other healthcare professionals and the community, are necessary.…”

“…14 To guarantee the ongoing quality of care throughout the postoperative discharge transition, systemic nursing interventions and clear communication, including collaboration and coordination with other healthcare professionals and the community, are necessary. 13,15 Some individuals reported unforeseen circumstances after surgery, such as reduced physical condition, psychological issues, and the adverse effects of painkillers. Previous research on postoperative recovery experience in patients found a "mismatch in expectations regarding the recovery experience."…”

Discharge transitional care programme for older adults after hip fracture surgery: a quasi-experimental study

“…The key themes were the 'challenge of discharge transition', 'physical and psychological distress during recovery', 'dependent compliance' and 'walking being taken for granted'. Participants recognised that rehabilitative exercises, walking, nutritional management, support from family and healthcare providers were key to recovery (Ko et al, 2021b). In addition, a mobile application was developed for rehabilitative instructions for hip fractures during the discharge transition (Ko et al, 2021a) and used in this programme.…”