Factors Considered by Interprofessional Team for Treatment Decision in Hip Fracture with Dementia.
Objectives: Patients with dementia are at high risk for hip fractures and often have poor outcomes when a fracture is sustained. Despite this poor prognosis, little data are available on what factors should be prioritized to guide surgical decision making in these cases. We aimed to understand the d...
| Published in: | Journal of the American Geriatrics Society Vol. 67; no. 6; pp. 1132 - 1138 |
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| Main Authors: | , , , , , , |
| Format: | Article |
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Wiley-Blackwell
Jun2019
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=136931927&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 136931927 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Jun2019 vid: 67 iid: 6 pid: 480 pub: Wiley-Blackwell artinfo: ui: 136931927 10.1111/jgs.15856 ppf: 1132 ppct: 6 formats: tig: atl: Factors Considered by Interprofessional Team for Treatment Decision in Hip Fracture with Dementia. aug: au: Baker, Alice C. Ambrose, Catherine G. Knudson, Paula L. Saraykar, Smita S. Piller, Linda B. McCurdy, Sheryl A. Rianon, Nahid J. affil: UTHealth McGovern Medical School, Houston Texas University of Texas M.D. Anderson Cancer Center, Houston Texas UTHealth School of Public Health, Houston Texas su: Hospital care of older people Interprofessional relations Interviewing Life expectancy Life skills Medical personnel Pain management Advance directives (Medical care) Qualitative research Psychosocial factors Social support Geriatric health care teams Hip fractures Care of dementia patients Treatment of fractures Orthopedists Geriatricians Ethicists Occupational therapists Physical therapists Bone fractures -- Prognosis Computer software Dementia Bone fractures Frail elderly Health care teams Hip joint injuries Psychology of nurses Orthopedics Surgeons Decision making in clinical medicine Comorbidity Patients' families Disease complications Injury risk factors sug: subj: Hospital care of older people Interprofessional relations Interviewing Life expectancy Life skills Medical personnel Pain management Advance directives (Medical care) Qualitative research Psychosocial factors Social support Computer, computer peripheral and pre-packaged software merchant wholesalers Computer and Computer Peripheral Equipment and Software Merchant Wholesalers Computer and software stores Software publishers (except video game publishers) Offices of Physical, Occupational and Speech Therapists, and Audiologists Other Individual and Family Services Geriatric health care teams Hip fractures Care of dementia patients Treatment of fractures Orthopedists Geriatricians Ethicists Occupational therapists Physical therapists Bone fractures -- Prognosis Computer software Dementia Bone fractures Frail elderly Health care teams Hip joint injuries Psychology of nurses Orthopedics Surgeons Decision making in clinical medicine Comorbidity Patients' families Disease complications Injury risk factors keyword: dementia hip fracture interprofessional team treatment decision making dementia hip fracture interprofessional team treatment decision making ab: Objectives: Patients with dementia are at high risk for hip fractures and often have poor outcomes when a fracture is sustained. Despite this poor prognosis, little data are available on what factors should be prioritized to guide surgical decision making in these cases. We aimed to understand the decision‐making process for older dementia patients hospitalized after hip fractures. Design: We performed a qualitative analysis of in‐depth elite interviews conducted with a clinical care team involved in management of patients with dementia after hospitalization for hip fractures. Setting: Interviews were conducted with an interprofessional team involved in the care of patients with dementia after being hospitalized for hip fractures. Participants: Interviewees included nine orthopaedic surgeons, three hospitalists, three geriatricians, five nurses, three occupational therapists, three physical therapists, and two clinical ethicists. Measurements: Verbatim transcripts of the interviews were analyzed and coded using QSR International's NVivo 10 qualitative database management software. Results: The three main themes that most interviewees discussed were pain control, functional status, and medical comorbidities. Interviewees brought up many factors related to restoring functional status including baseline functional status, rehabilitation potential, social support, and the importance of mobility. Dementia and its impact on rehabilitation potential were mentioned by all geriatricians. Conclusion: Although frailty, prognosis, and life expectancy were largely absent from the responses, the emphasis on dementia, advanced directives, and involving family or caregivers by the three geriatricians indicates the importance of including geriatricians in the decision‐making team for these patients. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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