The Effect of Spouses' Involvement Through Case Management in Older Patients' Fast-track Program

University of Aarhus58 enrolled

Overview

Patients in fast-track programmes are required to take an active part in their treatment and rehabilitation. Spouses of older patients can often provide valued practical and emotional support, reducing stress, pain and length of stay - yet they are seldom invited to participate in a supporting role. The aim of this study is to investigate the effect of spouses' involvement in older patients fast-track treatment programs using case management as intervention. A two-group quasi-experimental design with pre-test and repeated post-test measures (protocol approved in November 2012) was used. Patients aged 65 years or older going through a fast-track programme for a total hip replacement and their spouses was recruited in dyads from one Danish orthopaedic ward for the intervention group (n=15) and for the control group (n=14). Data was collected from both groups at baseline, two weeks and three months after surgery. Outcome measures for patients include: functional status, nutrition, pain, depression and healthcare consumptions; and for spouses: caregiver satisfaction and difficulties and anxiety.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Arthroplasty, Replacement, Hip

Interventions

Eligibility

Sex: ALLMin age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Patients * 65 years of age or older * undergoing a total hip replacement due to arthritis * live with their spouses * speak, read and understand Danish without an interpreter * have their spouses present at the mandatory pre-information meeting in the outpatient facilities. Inclusion Criteria: Spouses * presence at the pre-information meeting Exclusion Criteria: Patients * They cannot receive home care, be placed in a nursing home or be permanent users of wheelchairs Exclusion criteria: Both * Index score at \>24 assessed on the Mini-Mental Stats Examination (MMSE) * Index score of \<6 assessed on the Charlson Comorbidity Index

Outcomes

Primary Outcomes

Functional status/ activities of daily living measured by the Barthel-100, which is a 10-item scale

Time frame: Three months

Caregiver satisfaction assessed using the 30-item Carer's Assessment of Satisfaction Index (CASI)

Time frame: Three months

Secondary Outcomes

Nutritional improvements measured using the Mini Nutritional Assessment tool (MNA-SF)

Time frame: Three months

Pain improvements measured using the separate patient-relevant dimension of pain in the Hip Disability and Osteoarthritis Outcome Score (HOOS)

Time frame: Three months

Depression using the 15-item short form binary reported measurement of the Geriatric Depression Scale (GDS-15)

Time frame: Three months

Caregiver difficulties assessed through 15 items selected from the 30-item Carer's Assessment of Difficulties (CADI)

Time frame: Three months

Anxiety assessed using the Generalized anxiety disorder (GAD-7) scale

Time frame: Three months