HIP FRACTURE RECOVERY IN OLDER WOMEN: THE INFLUENCE OF SELF-EFFICACY, DEPRESSIVE SYMPTOMS AND STATE ANXIETY (ELDERLY).
Contributors: University of California, San Francisco.
Published: 1992
Number of pages: 336
Subjects: Health Sciences, Nursing.; Psychology, Clinical.; Gerontology.
Description: This study investigated the influence of self-efficacy expectations, state anxiety and depressive symptoms, on recovery of physical functioning in older women the first three months after hip fracture surgery. A model was developed from the literature and examined in a prospective cohort study with a convenience sample of 63 patients ranging from 57 to 92 years (mean age = 77.5 years) from 10 northern California urban hospitals. The sample was 82% white, 13% Hispanic, 3% Asian, 2% black; 52% were widowed and 57% had a college or higher degree. Data collection techniques included face to face postoperative interviews, completion of self-reported questionnaires, and follow-up interviews by telephone at 4 and 12 weeks after surgery.

Self-efficacy beliefs were assessed with the Efficacy Expectation Scales for General Activities, a Hip Surgery Functional Efficacy Scale, and relevant activity checklists; mood was assessed with the Geriatric Depression Scale and State Anxiety Inventory. Other instruments included the Short Portable Mental Status Questionnaire, an interview guide to assess recovery experiences, and a medical record abstract form.

Less depressive symptoms and state anxiety, and higher self-efficacy expectations correlated with increased self-reported activity over time. In-hospital self-efficacy beliefs, depressive symptoms, serum blood urea nitrogen, and total protein predicted 42% of the variance in Week 4 recovery. In-hospital efficacy beliefs, state anxiety, depressive symptoms, and admission number of diagnoses and medications predicted 37% of the variance in Week 12 recovery. A second model using Week 4 efficacy beliefs, state anxiety and depressive symptoms, and admission number of medications predicted 42% of the variance in Week 12 recovery.

Over the 12 week recovery period, self-efficacy beliefs increased, state anxiety gradually decreased, depressive symptoms remained stable, perceived recovery increased, and self-reported activity increased. Ethnic differences were found for perceived recovery. Interactive effects were found for age cohorts in self-efficacy beliefs and self-reported activities. Since efficacy beliefs and mood are amenable to intervention, hip fracture recovery could be enhanced through structured clinical approaches in the early recovery period.
Notes: Source: Dissertation Abstracts International, Volume: 54-03, Section: B, page: 1337.

Thesis (D.N.S.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1992.

School code: 0034.