Exploring older adults’ perceptions of a patient-centered education manual for hip fracture recovery: “everything in one place&rdquo

Karen Tsui,1,2,* Lena Fleig,1,3,4,* Dolores P Langford,2,5 Pierre Guy,1,2,6 Valerie MacDonald,7,8 Maureen C Ashe1,31Centre for Hip Health and Mobility, The University of British Columbia, 2Vancouver Coastal Health, 3Department of Family Practice, The University of British Columbia, Vancouver, BC, Canada; 4Health Psychology, Freie Universität Berlin, Berlin, Germany; 5Department of Physical Therapy, The University of British Columbia, 6Department of Orthopaedics, 7School of Nursing, The University of British Columbia, Vancouver, 8Fraser Health Authority, Surrey, BC, Canada*These authors contributed equally to this workPurpose: To describe older adults’ perspectives on a new patient education manual for the recovery process after hip fracture.Materials and methods: The Fracture Recovery for Seniors at Home (FReSH) Start manual is an evidence-based manual for older adults with fall-related hip fracture. The manual aims to support the transition from hospital to home by facilitating self-management of the recovery process. We enrolled 31 community-dwelling older adults with previous fall-related hip fracture and one family member. We collected data using a telephone-based questionnaire with eight five-point Likert items and four semi-structured open-ended questions to explore participants’ perceptions on the structure, content, and illustration of the manual. The questionnaire also asked participants to rate the overall utility (out of 10 points) and length of the manual. We used content analysis to describe main themes from responses to the open-ended interview questions.Results: Participants’ ratings for structure, content, and illustrations ranged from 4 to 5 (agree to highly agree), and the median usefulness rating was 9 (10th percentile: 7, 90th percentile: 10). Main themes from the content analysis included: ease of use and presentation; health literacy; illustration utility; health care team delivery; general impression, information support from hospital to home; emotional and decision-making support; and the novelty of the manual.Conclusion: The FReSH Start manual was perceived as comprehensive in content and acceptable for use with older adults post-fall-related hip fracture. Participants expressed a need for delivery and explanation of the manual by a health care team member.Keywords: falls, patient education, health literacy, self-management, discharge planning