Acute confusion states, pain, health, functional status and quality of care among patients with hip fracture during hospital stay

SummaryAimThe aim of the study was to investigate: acute confusional states, pain and pain relief, physical health, psychological well-being and functional status among patients with hip fracture during hospital stay. A further aim was to describe patient’s perceptions of quality of care.MethodForty-nine patients with hip fracture ⩾70 years old were consecutively included in the study at two hospitals in Sweden. Data were collected by interview and observation using structured questionnaires at four occasions.ResultsThe incidence of acute confusion was 32% on admission and the day after surgery and 14% the day before discharge. Additional diagnosis and on-going medication were significantly more common among confused patients. Patients with confusion experienced more intense pain at rest on admission and the day before discharge than non-confused patients. On perceived reality in quality of care patients’ reported most favourable scores with regard to respect and empathy from the nurses and less favourable scores with regard to the information of responsible persons and information after procedures. The overall subjective importance of quality of care was higher than on the perceived quality of care.ConclusionMore attention, systematic observations and preventive actions should be taken when there are signs of acute confusion, pain and pain relief among patients with hip fracture. Patients’ ratings of the subjective nature of care were higher than the perceived reality of quality of care and needs to be given attention since subjective importance reflects how the patients want their care to be.