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This study aims to investigate the impact of hospitalisation on physical and cognitive performance in patients aged 65 and older admitted with an orthopaedic injury. This will be achieved by asking patients to participate in a series of physical and cognitive performance questionnaires and tests. These questionnaires and tests will be performed by the patients as close to their admission as possible and then again at day 7 of hospitalisation (or discharge if earlier) and at 4-6 weeks after discharge. However, if a patient's hospital stay lasts more than 30 days, they will be asked to take part in the interim data collection timepoint.
To summarize, patients will be assessed at least 3 times, 4 if your hospital stay is longer than 30 days. The first and second assessments will be in the hospital, and the third will be 4-6 weeks after discharge at you home (or where is appropriate). Additionally, patients will be asked to wear an activity watch between the first and second assessment.
The study will also explore patients experiences of their hospital stay and opinions on deconditioning, including the views and opinions of hospital staff. This information will be gathered by having interviews with a sample of the patients who took part in the questionnaires and tests and by having interviews with hospital staff. The interview will be conducted by the main researcher, Thomas Cartledge, and will take place either over the phone, online or in-person, depending on your preference. The interviews will be audio and/or video recorded, however the recordings will be deleted immediately once transcription is completed. The duration of the interview will last approximately 30-60 mins.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Older patients with orthopaedic conditions/injuries | This cohort will take part in the physical and cognitive questionnaires and tests at all 3 (4 if interim is needed) time points. 20 patients of this cohort will take part in one semi-structured interview. | ||
| Southampton General Hospital Staff | 10 hospital staff to take part in one semi-structured interview. |
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| Measure | Description | Time Frame |
|---|---|---|
| Muscle strength measured via a hand held dynamometer. | From enrolment to the last data collection point at 4-6 weeks post discharge | |
| Muscle mass measured via Bioelectrical Impedance Analysis. | The specific measure used will be fat free mass (FFM) | From enrolment to the last data collection point at 4-6 weeks post discharge. |
| Sarcopenia risk assessed via the SARC-F questionnaire. | Strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire. Using a scale ranging from 0 to 10, with a higher score indicating a higher sarcopenia risk. | From enrolment to the last data collection point at 4-6 weeks post discharge. |
| Functional mobility measured via the Short Physical Performance Battery (SPPB) questionnaire. | The SPPB score ranges from 0 to 12 points, with a higher score indicating better functional mobility. | 4-6 weeks (discharge to the final data collection point). |
| Health-related quality of life measured by the EQ-5D questionnaire. | The EuroQol-5D (EQ-5D) is a two part questionnaire. The first part is a descriptive system using five dimensions to describe health (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). The second part is a visual analogue scale (VAS) where participants indicate their overall health by drawing a line on a scale from 100 (best imaginable health) to 0 (worst imaginable health). | From enrolment to the last data collection point at 4-6 weeks post discharge. |
| Physical function measured via the Barthel Index questionnaire. |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital re-admission rate | Will see if patients are readmitted to hospital within 3 months. Information abstracted from medical records. | 3 months |
| Hospital re-admission rate | Will see if patients are readmitted to hospital within 6 months. Information abstracted from medical records. |
| Measure | Description | Time Frame |
|---|---|---|
| Perceptions and attitudes towards hospital-associated deconditioning measured via semi-structured interviews. | Interviews will be conducted with older orthopaedic patients and hospital staff. | Time frame for patients will be their last hospital admission (approx 7 days long) and staff will be asked to recall information from their last 2 months of work. |
Patient criteria:
Inclusion:
Exclusion:
Hospital staff criteria:
Inclusion:
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Older adults admitted to SGH with an acute orthopaedic condition/injury.
Hospital staff who work at SGH who work with older orthopaedic inpatients.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospitals Southampton Foundation Trust | Southampton | Hampshire | SO16 6YD | United Kingdom |
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The original Barthel Index will be used, which uses a score ranging from 0 to 100. A higher score indicates a better physical function.
| From enrolment to the last data collection point at 4-6 weeks post discharge. |
| Cognitive impairment measured via The Montreal Cognitive Assessment (MoCA) score. | The MoCA score ranges from 0 to 30. A score of 26 or higher is generally considered normal, with lower scores indicating potential cognitive impairment. | From enrolment to the last data collection point at 4-6 weeks post discharge. |
| Delirium measured via the 4AT score. | The 4AT test is scored from 0-12. A score of 0 suggests no delirium and no moderate-severe cognitive impairment. A score from 1-3 suggests cognitive impairment but not delirium. A score of 4 or more suggest delirium. | From enrolment to the last data collection point at 4-6 weeks post discharge. |
| 6 months |
| Exploring practical ways of preventing hospital-associated deconditioning via semi-structed interviews. | Interviews will be conducted with older orthopaedic patients and hospital staff. | Time frame for patients will be their last hospital admission (approx 7 days long) and staff will be asked to recall information from their last 2 months of work. |
| Exploring barriers and facilitators to physical and cognitive risk factors of hospital-associated deconditioning via semi-structed interviews. | Interviews will be conducted with older orthopaedic patients and hospital staff. | Time frame for patients will be their last hospital admission (approx 7 days long) and staff will be asked to recall information from their last 2 months of work. |