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Rehabilitation for people with dementia recovering from hip fracture (Cross_U17SF)

Project Description

Hip fracture is three times as likely in PwD compared to people without dementia, and PwD who fracture their hip have specific rehabilitation needs. Current UK pathway for hip fracture rehabilitation emphasises early supported discharge with ongoing multidisciplinary rehabilitation for those who have ‘the mental ability to participate’.  PwD can clearly benefit from rehabilitation, but the evidence for how this can best be tailored for PwD is lacking as they are frequently excluded from studies.

This PhD studentship will develop a clearer understanding of which rehabilitation strategies and discharge planning is most appropriate for PwD who fracture their hip. This will be conducted through exploration of theory from literature, observation and subsequent modelling. The resulting knowledge will support person-centred rehabilitation planning and development of responsive care pathways. The project will have three cumulative stages. (i) Determine the evidence base through as systematic review for rehabilitation in PwD who break their hip including: exercise training, different exercise frequencies and intensities, occupational therapy interventions and discharge planning from the rehabilitation perspective. (ii) Identify components of rehabilitation for this population through an observational study of PwD (n=3-5 across different hospitals) who have broken their hip and are receiving rehabilitation. Occupational therapists, physiotherapists and therapy assistant staff interacting with participants and family carers will be observed throughout the rehabilitation process up to discharge.  (iii) Building on the first two phases, this phase uses ‘event reconstruction’ methodology which focuses on specific treatment sessions (episodes or events), behaviours in these interventions, justification for behaviours, and feelings about those sessions. This phase consists of ‘event reconstruction’ interviews with purposively selected different rehabilitation professions (n = 15) to examine specific instances of caring for PwD with broken hips.

References

i) Smith TO, Hameed YA, Henderson C, Cross JL, Sahota O, Fox C. Effectiveness of post-operative management strategies for adults with dementia following hip fracture surgery. Cochrane Database of Systematic Reviews [Internet]. John Wiley & Sons, Ltd; 2011 [cited 2014 Mar 28]. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010569/abstract

 

ii) NICE. Hip fracture: The management of hip fracture in adults [Internet]. 2014. Available from: http://www.nice.org.uk/

 

iii) McGilton KS, Davis AM, Naglie G, Mahomed N, Flannery J, Jaglal S, et al. Evaluation of patient-centered rehabilitation model targeting older persons with a hip fracture, including those with cognitive impairment. BMC Geriatr. 2013;13:136

 

iv) Allen J, Koziak A, Buddingh S, Liang J, Buckingham J, Beaupre LA. Rehabilitation in patients with dementia following hip fracture: a systematic review. Physiother Can Physiothérapie Can. 2012;64(2):190–201.


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Information

  • Start date: Flexible
  • Programme: PhD
  • Mode of Study: Full Time

How to Apply

Fees & Funding

Entry Requirements

  • Acceptable First Degree:

  • Minimum Entry Standard: Minimum entry 2:1 or Masters degree