This quasi-experimental study evaluates the effectiveness of a digitally enhanced nursing discharge teaching program for older adults recovering from limb fractures. As patients transition from the acute trauma ward to home care, they often face significant challenges managing pain, psychological distress, and daily functioning. This study compares a structured, digitally supported educational intervention against standard hospital discharge care. The primary goal is to determine if the digital program improves patients' pain intensity, depressive symptoms, and overall quality of life during the first six weeks post-discharge compared to routine care.
Geriatric trauma patients, specifically those suffering from limb fractures, experience a high risk of poor functional and psychological outcomes following hospital discharge. Standard discharge teaching is often constrained by the fast-paced nature of acute trauma wards, limiting patients' ability to retain critical recovery information. To address this, the current study implemented a digitally enhanced nursing discharge teaching program. This study utilized a non-randomized, quasi-experimental design with two parallel arms: a contrast group receiving standard routine discharge care, and an experimental group receiving the digitally enhanced program. The digital intervention included interactive, multimedia educational content delivered prior to discharge, supplemented by structured telephone follow-ups by nursing staff to reinforce symptom management, mobility safety, and recovery strategies at home. Participants were recruited continuously based on acute hospital admissions. The primary outcomes assessed were pain intensity (Numeric Pain Rating Scale), depressive symptoms (Geriatric Depression Scale-Short Form), and overall quality of life (WHOQOL). Data were collected at three distinct time points: baseline (prior to hospital discharge), two weeks post-discharge, and six weeks post-discharge. The study aims to evaluate the clinical efficacy of this digital transition model and its feasibility for integration into routine geriatric trauma care.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
90
A structured transitional care program utilizing interactive, multimedia digital content to teach pain management, psychological coping, and recovery strategies. The initial digital education provided in the acute ward is supplemented by scheduled telephone follow-up sessions conducted by nursing staff to reinforce the material and support patients in their home environment.
Kaohsiung Medical University
Kaohsiung City, Taiwan
The World Health Organization Quality of Life Questionnaire
The WHOQoOL-BREF will be used to measure quality of life. Six popular generic instruments of HRQOL are commonly used as disability outcome measures, some of them were developed later were tested trans-culturally in extensive research programs such as the WHOQoL-BREF. The WHOQoL-BREF is a 26-item scale that is measure along with four subscales including physical, psychological, social relationship and environment domains. Scores range from 1 to 5 with higher scores indicating higher quality of life. The reliability and validity of the Chinese WHOQoL-BREF have been tested in patients with traumatic injuries, but not in geriatric trauma. Thus, the Cronbach's alpha for this study will be retested.
Time frame: Baseline (1 day prior to hospital discharge), 2 weeks post-discharge, and 6 weeks post-discharge.
The Numeric Pain Rating Scale
The NPRS is a one-dimensional measure of pain intensity in adults. A NPRS has similar anchors at the extremes but offers numbers from 0 through 10. It is well known and broadly used scale in clinical settings. No further reliability and validity tests are needed.
Time frame: Baseline (1 day prior to hospital discharge), 2 weeks post-discharge, and 6 weeks post-discharge.
The Geriatric Depression Scale Short Form
The GDS-SF is a 15-item scale used to identify depression in older adults. It is from the original GDS developed by Sheikh and Yesavage to examine the self-perceived emotions of older adults. The version will be used in this study is a validated Chinese that has been tested its reliability in geriatric older population in Taiwan. The GDS-SF features binary scores for a total score of 0-15. A higher score indicates a more severe of depression. In the GDS-SF, a score of 0 to 5 is normal, a score \> 5 suggests depression, and a score ≥ 10 is almost indicative of depression. The Cronbach's alpha for this study will be retested.
Time frame: Baseline (1 day prior to hospital discharge), 2 weeks post-discharge, and 6 weeks post-discharge.
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