Clinically relevant behaviors in elderly hip fracture inpatients

Helen H. Dorra, Eric J. Lenze, Yookyung Kim, Benoit H. Mulsant, Michael C. Munin, Mary Amanda Dew, Charles F. Reynolds

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Objective: To examine the range of behaviors documented by inpatient rehabilitation staff and the association of these behaviors with functional outcome, in elderly persons undergoing rehabilitation after hip fracture. Method: Subjects were 137 patients, aged 60 and older, admitted to a rehabilitation hospital after a hip fracture, defined as having either a good or poor rehabilitation outcome based on change in Functional Independence Measure motor subscale scores during the course of their admission. Their charts were systematically reviewed for nursing and therapy staff documentation of behaviors. Prevalence of behaviors was compared between good and poor rehabilitation outcome groups. Results: Disturbances in cognition and rehabilitation participation were common and were associated with poorer rehabilitation outcome. Behaviors reflective of depression and anxiety were relatively uncommon and not associated with rehabilitation outcome. Conclusions: Rehabilitation staff frequently detect and document disturbances in cognition and participation that are associated with poorer rehabilitation outcome. It is recommended that staff observations be routinely added to mental health evaluations. Additionally, routine mental health screening and required staff documentation of behaviors would improve case detection rate.

Original languageEnglish
Pages (from-to)249-259
Number of pages11
JournalInternational Journal of Psychiatry in Medicine
Volume32
Issue number3
DOIs
StatePublished - Dec 1 2002
Externally publishedYes

Keywords

  • Aged
  • Cognition
  • Depression
  • Motivation
  • Orthopedics
  • Rehabilitation outcome

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