| Objectives1.To understand the psychological experience of post-traumatic growth of elderly patients after hip fracture surgery.2.To investigate the influencing factors of post-traumatic growth of elderly patients after hip fracture surgery by cross-sectional questionnaire.3.To analyzed the path of social support,resilience and self-disclosure in the post-traumatic growth of elderly patients with hip fracture based on the theoretical model of post-traumatic growth.Methods1.Semi-structured interviews were conducted on 15 elderly patients after hip fracture surgery in two tertiary hospitals in Yangzhou City,Jiangsu Province from February 2022 to April 2022 using phenomenological research methods in qualitative studies.Interview transcripts were analyzed and coded using the Claizzi analysis program.To extract the theme of psychological experience of post-traumatic growth of elderly patients with hip fracture and reflect the positive psychological changes of elderly patients with hip fractures.2.Cross-sectional questionnaire study:From April 2022 to December 2022,292 patients who met the inclusion and exclusion criteria were selected as research objects from orthopedics and trauma departments of two tertiary hospitals in Yangzhou City,Jiangsu Province.The self-compiled general data questionnaire,Post traumatic Growth Inventory(PTGI)and Perceived Social Support Scale(PSSS),Connor-Davidson Resilience Scale(CD-RISC)and Distress Disclosure Index(DDI)were used to collect patients’ general information and psychological data.Excel was used to establish a database,and SPSS26.0 and AMOS24.0 were used for statistical analysis.The main statistical methods used included descriptive analysis,independent sample t test,one-way analysis of variance,Pearson correlation analysis,multiple linear regression,and path analysis.Results1.The trajectory of psychological experience of post-traumatic growth in elderly patients with hip fracture is mainly manifested as disruption and stress(limited daily activities,inner fear,guilt for family members,uncertainty about the future);Cognitive processing(questioning and reflection);Effective coping(increased self-strength,support from family and friends,support from health care professionals,power by example);Life perception(spiritual level,behavioral level).2.The post-traumatic growth of the elderly patients with hip fracture was 53.90±16.97 points,the score of sub-dimension personal strength was 7.99±3.48 points,the score of relationship with others was 8.06±3.37 points,the score of life perception was 16.26±6.60 points,and the score of new possibility was 10.71±4.45 points.Self-transformation 10.89±4.65 points.Univariate analysis showed that age,marital status,surgical method and subjective feeling severity had statistically significant differences in the total score of post-traumatic hip fracture growth in the elderly(P<0.05).3.Correlation analysis showed that the total score of post-traumatic growth was positively correlated with self-disclosure,perceived social support and psychological resilience(r=0.666,0.449,0.609,P<0.05).4.Regression analysis showed that Age(β=-3.623,),marital status(β=-9.480),surgical method(β=6.490),subjective feeling severity(β=1.581),perceived social support(β=0.110),self-disclosure(β=0.421)and psychological resilience(β=0.107)were the main factors of post-traumatic growth in elderly patients with hip fracture To influence factors,62.8%of the total variation could be explained.5.Path analysis showed that understanding social support could directly promote post-traumatic growth in elderly patients with hip fracture(effect value=0.158,P<0.05),accounting for 35.11%of the total effect.Understanding that social support can promote post-traumatic growth through self-disclosure(effect value=0.190,P<0.05)accounted for 42.22%of the total effect;Understanding social support can also promote post-traumatic growth through psychological resilience(effect value=0.026,P<0.05)accounting for 5.78%of the total effect;Understanding social support can also promote the post-traumatic growth level of patients through self-disclosure to promote mental resilience(effect value=0.076,P<0.05),accounting for 16.89%of the total effect.Conclusion1.Elderly patients with hip fracture have experienced post-traumatic growth during hospitalization,which has a great relationship with patients’ families and medical resources.Clinical medical staff should take targeted nursing measures according to the performance of patients in different periods to promote the mental health development of patients.2.The posttraumatic growth of elderly patients with hip fracture is at a moderate level,and the main influencing factors are age,marriage,subjective feeling severity,surgical method,perceived social support,self-disclosure and psychological resilience.The older age,no spouse or widower is not conducive to the generation of post-traumatic growth.It is suggested that the clinical medical staff should identify the patients who need special attention in the early stage according to the above influencing factors,and promote the mental health development of patients in the early stage.3.It is understood that social support can not only directly affect the post-traumatic growth level of elderly patients with hip fracture,but also jointly affect the post-traumatic growth level of patients through self-disclosure and psychological resilience. |
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