mHealth to improve experience, adherence to pharmacological treatment, and positive mental health in patients diagnosed with femur fractures: protocol for a quasi-experimental study

Background: Considering the prognosis of femur fractures worldwide, the ageing of our society, and the problems in adherence to treatment found in these patients, it is believed that mobile health can have a positive impact on the process and quality of care. Objective: We aim to evaluate the effectiveness of a pharmacological educational nurse intervention with Myplan app with regard to knowledge, adherence to pharmacological treatment, and positive mental health of patients with femur fractures. Methods: A nonrandomized, quasi-experimental study will be carried out with a pretest-posttest control group. It will include 278 older patients diagnosed with femur fractures, with a Glasgow Coma Scale of 15 and access to mobile devices. Patients with psychological pathologies and cognitive impairment or patients treated in isolation will be excluded. Study variables are as follows: sociodemographic variables (AdHoc Form), patient experience (Patient Experience Questionnaire-15), adherence to pharmacological treatment (Morisky-Green questionnaire), and positive mental health (Positive Mental Health questionnaire). The measurements will be taken 24 hours after admission, upon discharge, and 25 days after discharge. Results: Enrollment commenced in October 2022. Data collection will be completed in April 2023. Conclusions: The results of this study will offer evidence of the effectiveness of a pharmacological educational nurse intervention by means of a free smartphone app. If its efficacy is demonstrated and the results are acceptable, it could mean an improvement in the care of patients with femur fractures, and this technology could be used to guide other training interventions in patients with other pathologies

Prevention of Pressure Ulcers and Heel Friction Injuries: Randomized Factorial Clinical Trial in a Traumatology setting

La prevención de úlceras por presión, y lesiones por fricción, en talón, todavía es un reto en el cuidado de gente mayor con fractura de fémur. El encamamiento hasta la intervención, tener una extremidad inmovilizada, y no poder realizar reposicionamientos hasta la intervención, confiere al talón una situación de vulnerabilidad frente estas lesiones. A pesar de las recomendaciones preventivas, no siempre se aplican las mismas medidas ni con los mismos recursos, dando lugar a diferentes intervenciones. Este es el caso del uso de taloneras de poliuretano y/o aplicación de ácidos grasos hiperoxigenados. Objetivo: comparar la eficacia del uso combinado de taloneras de espuma de poliuretano y ácidos grasos hiperoxigenados frente a la aplicación de éstas u otras medidas, aceite de oliva y almohadas, tanto por separado como frente a cualquiera de sus posibles combinaciones, en la prevención de úlceras por presión y lesiones por fricción en talón, en pacientes ingresados en una unidad de Traumatología de un hospital de tercer nivel tras presentar una fractura de fémur.Máster en Gestión Integral e Investigación de las Heridas Crónica

mHealth to Improve Experience, Adherence to Pharmacological Treatment, and Positive Mental Health in Patients Diagnosed With Femur Fractures: Protocol for a Quasi-Experimental Study

BackgroundConsidering the prognosis of femur fractures worldwide, the ageing of our society, and the problems in adherence to treatment found in these patients, it is believed that mobile health can have a positive impact on the process and quality of care. ObjectiveWe aim to evaluate the effectiveness of a pharmacological educational nurse intervention with Myplan app with regard to knowledge, adherence to pharmacological treatment, and positive mental health of patients with femur fractures. MethodsA nonrandomized, quasi-experimental study will be carried out with a pretest-posttest control group. It will include 278 older patients diagnosed with femur fractures, with a Glasgow Coma Scale of 15 and access to mobile devices. Patients with psychological pathologies and cognitive impairment or patients treated in isolation will be excluded. Study variables are as follows: sociodemographic variables (AdHoc Form), patient experience (Patient Experience Questionnaire-15), adherence to pharmacological treatment (Morisky-Green questionnaire), and positive mental health (Positive Mental Health questionnaire). The measurements will be taken 24 hours after admission, upon discharge, and 25 days after discharge. ResultsEnrollment commenced in October 2022. Data collection will be completed in April 2023. ConclusionsThe results of this study will offer evidence of the effectiveness of a pharmacological educational nurse intervention by means of a free smartphone app. If its efficacy is demonstrated and the results are acceptable, it could mean an improvement in the care of patients with femur fractures, and this technology could be used to guide other training interventions in patients with other pathologies. Trial RegistrationClinicalTrials.gov NCTT05669040; https://clinicaltrials.gov/ct2/show/NCTT05669040 International Registered Report Identifier (IRRID)DERR1-10.2196/4585

Profile of Patients with Dementia or Cognitive Impairment Hospitalized with a Proximal Femur Fracture Requiring Surgery

This study reports the characteristics of patients with dementia or cognitive impairment hospitalized with a proximal femur fracture requiring surgery. Methods: Multicentric descriptive longitudinal study conducted in three traumatology units, representing high-technology public hospitals across Spain. Data collection took place between August 2018 and December 2019 upon admission to hospital, discharge, one month and three months after discharge. Results: Study participants (n = 174) were mainly women (81.6%), and the mean age was 90.7± 6.3 years old. Significant statistical differences were noted in the decline of functional capacity at baseline and one month later, and after three months they had still not recovered. Malnutrition increased from baseline to the one-month follow-up. The use of physical restraints increased during hospitalization, especially bilateral bedrails and a belt in the chair/bed. After one month, 15.2% of patients had pressure ulcers. Although pain decreased, it was still present after three months. Conclusion: Hospitalization after hip surgery for elderly people with dementia or cognitive impairment negatively impacted their global health outcomes such as malnutrition and the development of pressure ulcers, falls, functional impairment and the use of physical restraints and pain management challenges. Hospitals should implement policy-makers’ strategic dementia care plans to improve their outcomes