| Objective: To explore the application effect of perioperative nursing intervention based on comprehensive geriatric assessment of the elderly in patients with hip fracture and frailty,in order to promote postoperative functional recovery and improve health outcomes.Methods: A total of 71 patients with hip fracture and frailty who were admitted to the Joint Surgery Department of a third-class a hospital in Xinjiang from October 2021 to July 2022 were selected as the research objects,All of the patients were divided into experimental group(n=34)and control group(n=34)with the method of random number table.The intervention group and the control group were implemented CGA-based perioperative comprehensive nursing interventions and orthopaedic routine perioperative nursing interventions respectively.The frailty,cognitive function,POCD,depression,pain,sleep quality,first time of getting out of bed,hospital stay,postoperative complications,hip joint function and ADL were compared between the two groups.Results:(1)There was no statistically significant difference between the two groups in terms of sociodemographic data,disease and surgical related data,and preoperative CGA results(P>0.05),which was comparable;(2)There was statistically significant difference in the frailty scores between the two groups on the first month,the third month after operation(P<0.05);(3)There was a statistically significant difference in the cognitive function scores between the two groups on the first day,the third day and the seventh day after operation(P<0.05).The incidence of POCD in the test group was lower than that in the control group on the 1st,3rd and 7th postoperative days(P < 0.05);(4)There was statistically significant difference in depression scores between the two groups on the first day,the third day and the seventh day after operation(P<0.05);(5)There was statistically significant difference in pain scores between the two groups on the first day,the third day and the seventh day after operation(P<0.05);(6)There was statistically significant difference in sleep quality scores between the two groups on the first day,the third day and the seventh day after operation(P<0.05);(7)Compared with the control group,the intervention group had shorter first time out of bed and hospital stay,lower incidence of complications,all of which had statistical significance(P<0.05);(8)There was statistically significant difference in hip joint function scores between the two groups on the day of discharge,the first month and the third month after operation(P<0.05);(9)There was statistically significant difference in the scores of ADL between the two groups on the day of discharge,the first month and the third month after operation(P<0.05).Conclusion: The perioperative comprehensive nursing intervention based on the CGA can improve the postoperative cognitive function and reduce the incidence of POCD;Relieve depression and postoperative pain,relieve depression and improve sleep quality;Improve the frailty,promote the recovery of hip joint function,and improve the ability of self-care in daily life;Shorten the time of first ambulation,reduce Length of stay and reduce the incidence of postoperative complications of patients.It provides a basis for clinical perioperative management of patients with hip fracture and frailty,and has certain reference value. |
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