Project Details
Abstract
Cognitive impairment, which occurs in 31-88% of postoperative elderly persons with
hip fracture, has been found to predict poor functional recovery and to increase risk of
mortality. However, a lack of study was found on post-operative processes and experiences
for these patients and families. This information will increase the understanding of the health
professions of the conditions of these patients and families and provide a base for
development of appropriate and effective interventions. Therefore, the purposes of this study
are to explore the post-operative recovery and family caregiving processes for hip-fractured
older persons with cognitive impairment, and to understand how it is different or similar to
those without cognitive impairment, in order to develop a theory to explain the variations in
this phenomenon.
Grounded theory method is selected to develop the conceptual framework of the
phenomena. Approval of Institutional Review Board (IRB) of CGMH will be obtained
before the study starts. Family caregivers of hip fractured older persons with and also
without cognitive impairment will be recruited to receive in-depth interviews. The family
caregiver-hip fracture older persons dyad will be obtained at the trauma wards or emergency
rooms of a medical center in Northern Taiwan. Interviews and participant observations will
be used to collect the data. Face-to-face interviews using an open-ended interview guide will
be conducted. The family caregivers will received 6 times of interview (before surgery,
before discharge and at 1st, 3rd, 6th, 12th months after discharge) and the hip fractured older
person will received cognitive and physical functioning assessments at the same time point
as the interviews take place. Initially, 30 dyad of family caregivers and patients (15 with and
15 without cognitive impairment) will be collected. Actual sample size will be determined
by theoretical sampling which refers to sampling based on concepts and incidents that are
relevant to the evolving theory. The comparison of the experiences of family caregivers of
patients with and without cognitive impairment will enhance the researcher’s theoretical
sensitivity of the concepts that unique to family caregivers of the patients with cognitive
impairment. Theoretical sampling will cease when the concept categories reach theoretical
saturation. Constant comparative analysis will be used to analyze the data. Specifically,
Glaser’s approach will be selected and implemented to allow more flexibility. We will
conduct audit trails, peer debriefing, triangulation of data from different collection methods,
obtaining rich descriptions of the contextual conditions, administering prolonged
engagement with extended visits, conducting theoretical sampling and member checks to
increase the overall trustworthiness of the study. The developed conceptual framework can
provide a culturally relevant perspective to the post-operative recovery and family
caregiving processes for hip-fractured older persons with cognitive impairment in Taiwan
and increase our knowledge base of gerontological nursing. Findings of this study can
provide a reference for clinical decisions and offer suggestions to better care for hip
fractured older persons with cognitive impairment and their family caregivers.
Project IDs
Project ID:PC10501-1644
External Project ID:MOST103-2314-B182-015-MY3
External Project ID:MOST103-2314-B182-015-MY3
Status | Finished |
---|---|
Effective start/end date | 01/08/16 → 31/07/17 |
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