An analysis of the present situation and barriers to home care for elderly patients with postoperative osteoporotic fractures
10.3761/j.issn.0254-1769.2025.02.011
- VernacularTitle:老年骨质疏松性骨折患者居家环境防护现况及障碍因素分析
- Author:
Chen QIU
1
;
Yuan GAO
;
Mengqi SHAO
;
Xiaojing SU
;
Qingmei WANG
;
Mi SONG
;
Xingxing HU
Author Information
1. 100048 北京市 解放军总医院第四医学中心创伤骨科
- Publication Type:Journal Article
- Keywords:
Osteoporosis;
Osteoporotic Fractures;
Aged;
Home Care;
Barriers;
Nursing Care
- From:
Chinese Journal of Nursing
2025;60(2):201-207
- CountryChina
- Language:Chinese
-
Abstract:
Objective A cross-sectional survey on the postoperative home care status and barriers was conducted among elderly patients with osteoporotic fractures nationwide,in order to provide a basis for promoting the improvement of standardized home care for elderly patients with osteoporotic fractures.Methods From October to November 2023,a survey on the current situation and barriers of home environment protection was conducted among elderly patients with osteoporotic fractures in the orthopedic wards of 594 hospitals across 31 provinces(autonomous regions/municipalities directly under the central government)using a convenience sampling method.Results A total of 14,349 questionnaires were distributed,and 12,496 valid questionnaires were collected,resulting in an effective response rate of 87.09％.Among the patients,5,502 cases(44.03％)had implemented home-based prevention and treatment of osteoporosis before the fracture.2 095(16.77％)of the patients experienced a subsequent fracture,of which 65.11％of the patients who experienced a subsequent fracture received medication intervention after the initial fracture,while 19.86％of the patients who experienced a subsequent fracture did not comply with the treatment for osteoporosis after the initial fracture.Additionally,77.66％(n=1 627/2 095)of the patients received community medical services after the initial fracture.Barriers to care factors in the home environment after fracture from the patient's perspective presented the complexity of the social-ecological system model in 6 dimensions at 2 levels:micro(basic personal situation,physiological factors,psychological factors,and behavioural factors),and meso(social support factors,and healthcare worker factors).Conclusion In the vast majority of elderly patients in China,before osteoporotic fracture,home-based measures to prevent osteoporosis have not been adequately implemented;after the initial osteoporotic fracture,the pathway of re-fracture prevention and management in the patient's home environment is not yet complete and its popularity needs to be improved;the barriers to home care faced by elderly patients with osteoporotic fracture are complex.It is recommended to promote effective linkages among hospitals,community health centres and families to strengthen the closed-loop management of re-fracture prevention and management.
