Active and Passive coping strategies of older adults with a recent hip fracture participating in an inpatient multidisciplinary geriatric rehabilitation program

Manju Sharma, Maaike Scheffers, Romke van Balen, Monica van Eijk, Wilco Achterberg

De abstractcommissie heeft op verzoek van de congrescommissie 6 abstracts geselecteerd die tijdens het Verenso najaarscongres 'Oud en benauwd' op 29 november 2018 middels een flitspresentatie gepresenteerd worden. Onderstaande abstract is daar een van.

Background

Functional recovery after hip fracture in older adults remains a challenge with only  limited modifiable factors influencing this process. Coping strategies of older adults with hip fracture may play an important role, however, evidence in support of this concept is lacking.

Methods

We conducted a secondary data analysis of the FIT-HIP trial. Hip fracture patients aged 65+ years admitted to eleven post-acute GR units in the Netherlands were included from 2016-2017. Coping was assessed using active and passive subscale of Utrecht Coping List (UCL). All 72 participants with completed baseline data on UCL were included in this study. Depression, anxiety, pain and quality of life were assessed using GDS-8, HADS-A, NPRS and EQ-5DVAS respectively. Patients with (extremely)high active- or passive coping strategies were dichotomized in predominantly active (PAC) respectively predominantly passive (PPC) coping strategy group and their corresponding residual groups using the existing UCL norm tables.

Results

Participants preferably used active coping strategies, with 33.3% included in PAC group vs 23.6% in PPC group. None of the patients used extremely high passive coping strategies. Thinking of possibilities to solve a problem was the most frequently used active coping strategy. Patients in PPC group scored higher on GDS-8 ( p = 0,04) and HADS-A (p = 0,00) than the residual group. No association was found between coping strategies and pain and quality of life.

Conclusion

In this study, older adults with hip fracture preferably used active coping strategies . Passive coping strategies were associated with higher levels of depression and anxiety. We advocate screening of coping strategies and neuropsychiatric symptoms at admission to GR program. Active coping strategies should be promoted and psychological assistance including cognitive behavioral therapy and treatment of depression and anxiety (as needed) should be provided to older adults with passive coping strategies, to help them learn effective coping skills in order to improve efficiency of rehabilitation.