Stressors and coping strategies in older people hospitalised for hip surgery following a fall: a multiple case study.

BACKGROUND: More than half of older persons admitted to an emergency department after a fall have a hip fracture and require surgery for a total hip replacement. This procedure has a high risk of postoperative complications and consequences for older persons, their informal caregivers, and the healthcare system. This study aimed to explore the perceptions of older persons, their informal caregivers and health professionals about intra-personal, inter-personal and extra-personal stressors arising from hip surgery following the fall of an older person hospitalised in orthopaedics, as well as the coping strategies used and the results obtained. METHODS: A qualitative multiple case study. The sample consisted of eight cases. Each case consisted of one older person, their informal caregiver and the professionals involved in their care: a nurse, an orthopaedic surgeon and a physiotherapist. A total of 32 participants were recruited. Data were collected between August 2018 and February 2019 in a public hospital in French-speaking Switzerland. Intra- and inter-case analyses were performed. RESULTS: Five topics emerged: two concerning stressors for older persons (the physical and psychological consequences of the fall and hospitalisation; the loss of relational and environmental markers and habits); two relating to the coping strategies used to face the stressors (being resilient and involved in their own care; partially meeting the older person's needs); and one regarding the results of the strategies used (reassurance through consideration of some of their needs). CONCLUSIONS: Older persons hospitalised for hip surgery after a fall are confronted with various intra-, inter- and extra-personal stressors and have to explore, together with their informal caregivers, strategies to cope with the consequences of these stressors. Healthcare professionals should possess efficient intervention strategies to help identify and support older persons who experience various types of stressors during hospitalisation for hip surgery following a fall.

Facilitators and barriers in implementing clinical nursing assessment in mental health care for older people: A multimethod approach.

With the aging of the population and the growing prevalence of dementia, specialized and collaborative nursing care is paramount in this area. To ensure better quality care, it is necessary to use effective and context-specific processes to implement evidence-based practices and more specifically clinical nursing assessment. This study aimed to identify and describe factors that may influence the implementation of clinical nursing assessment in mental health care for older people. The Consolidated Framework for Implementation Research was employed to guide evaluation in the pre-implementation phase in the specific context of mental health care for older people. Using a multimethod approach, interviews, focus groups, and a quantitative survey were conducted with a non-probability convenience sample. A total of 39 hospital nurses (registered nurses and head nurses) were interviewed. Analysis yielded five main factors, notably three barriers and two facilitators. Barriers include a lack of general nursing culture, deficiencies in leadership, and difficulties in communication and collaboration. Facilitators comprise team cohesion and the perceived benefits of the study.

Internal consistency and reliability of the Swiss-French translation of the venous leg ulcer self efficacy tool (VeLUSET).

OBJECTIVE: This study was conducted to assess the psychometric properties of the translated and adapted Venous Leg Ulcer Self Efficacy Tool (VeLUSET) in the new cultural context. DESIGN: Validation study SETTING: Three outpatient clinics in Western Switzerland. PARTICIPANTS: 32 consecutive persons with venous leg ulcers (VLU). MAIN OUTCOME MEASURES: To determine the internal consistency and reliability of the VeLUSET for use in a Swiss-French speaking venous leg ulcer population. RESULTS: Overall, the Cronbach alpha for the VeLUSET-FR was 0.96 (95% CI 0.93 to 0.98) on test and retest. Lin's concordance correlation coefficient of test and retest scores was 0.93 (95% CI 0.86 to 0.96). CONCLUSION: The results indicate that the VeLUSET-FR is a valid and reliable instrument for measuring self-efficacy among Swiss-French persons affected by a venous leg ulcer. Our findings show that the psychometric properties are similar to those of the original tool. Therefore, we suggest that the VeLUSET-FR can be effectively used for measuring self-efficacy in Swiss-French persons with VLU.