| Summary: | 碩士 === 長庚大學 === 護理學系 === 102 === Purpose：The purpose of this study was to explore the post-operative changes of sleep hours and physical activity level and their correlation between physical functional recovery, muscular strength of the affected side, quality of life, self-rated health, and blood sugar control for hip fractured elders with diabetes.
Research Design and Methods：This study was a secondary analysis of data on 36 community-dwelling elders with hip fracture and diabetes who were 60 years or older from a prior longitudinal study. SenseWear armband (BodyMedia, Inc., USA) was used to record sleeping hours and physical activity level. Hand-held dynamometer was used to examine muscular strength of the affected side. One Touch machine was used to examine the blood sugar. Other measures include Chinese Barthel Index, Lawton’s Instrumental Activities of Daily Living Scale, Short Form-36 Taiwan version and EQ-VAS visual analog scale. Data were analyzed by the generalized estimating equations approach to examine correlation between longitudinal changes of sleep hours and physical activity level and hip fractured elders’ health outcomes during the first 6 months after hospital discharge.
Results：We found that hip fractured elders with diabetes who did not have normal sleep hours had poorer outcomes in self-care ability of medication management, muscular strength of the affected side, and blood sugar control (post cibum, after meals;ante cibum, before meals) than those who had normal sleep hours. However, there were no statistically significant differences between two sleep type groups in quality of life and self-rated health during the first 6 months after postsurgical discharge. We also found that better physical activity level of the patients during the first 6 month following discharge was associated with better health outcomes especially in ADL performances, transfer ability, walking ability, and overall IADL ability to use telephone, ability to do laundry, ability to handle finances, muscular strength of the affected side and general health perceptions. However, there were no significant relationships between physical activity level and self-rated health, blood sugar control.Considering both sleep hours and physical activity level , we found that did not have normal sleep hours also had poorer outcomes in self-care ability of medication management, muscular strength of the affected side, and blood sugar control (post cibum, after meals;ante cibum, before meals) than those who had normal sleep hours. Better physical activity level was associated with better ADL performances, transfer ability, walking ability, and overall IADL ability to use telephone, ability to do laundry, ability to handle finances, muscular strength of the affected side. Based on this study, more attention needs to be paid to the consistent sleep hours and activities of hip fractured older persons with diabetes during the first 6 months following the surgery, in order to improve their self-care ability, muscular strength, quality of life and blood sugar control.
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