Rehabilitation therapy self-efficacy and functional recovery after hip fracture

Abstract

Little is known about the role of psychological factors in the functional recovery process of hip fracture patients. This study employed a prospective cohort design to test the hypothesis that hospitalized hip fracture patients with greater reported self-efficacy for conducting rehabilitation therapy would have a greater likelihood of recovering to a pre-fracture level of locomotion function six months after the fracture. This hypothesis was tested controlling for pre-fracture level of function and depressive symptoms reported during hospitalization for surgical repair. An original measure of rehabilitation therapy self-efficacy was evaluated prior to hypothesis testing. Study patients were recruited from two hospitals, interviewed during hospitalization and followed up six months later. Patients included in hypothesis test analyses (n = 24) were mostly women (82%) with a mean age of 79 years. Results showed that patients with higher self-efficacy scores had a greater likelihood of locomotion recovery, controlling for pre-fracture locomotion function level (adjusted odds ratio (AOR) = 1.21; 95% confidence interval (CI) = 1.00-1.45; P= 0.05). This positive association between rehabilitation therapy self-efficacy and likelihood of locomotion recovery persisted after adding depressive symptoms (the Center for Epidemiological Studies-depression (CES-D) score) to this logistic regression model (AOR for self-efficacy = 1.18; 95% CI = 0.99-1.42; P= 0.07). It is concluded that rehabilitation therapy self-efficacy is a potentially important psychological factor in helping hip fracture patients recover locomotion functioning.