الفهرس 
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Abstract
Trochanteric fracture is a medical condition in which there is a break in the continuity of the femoral bone in the area between the greater and lesser trochanters. Trochanteric fracture is considered a devastating injury that affecting the patients’ physical, mental, and social function. Several factors are associated with increasing the risk of trochanteric fracture such as; age, sex, chronic medical conditions, malnutrition, physical inactivity and excessive alcohol consumption. After trochanteric surgery, most of patients suffering from poor self care practices including ADLs and IADLs even 1 year post surgery, which in turn has negative effect on patients’ general health and their health related quality of life. Therefore, The role of nurses post trochanteric surgery is central, imperative and can be concluded in; coordination of care, continuous assessment, minimizing complications, providing education, improving of patient’ self care practices, through prevention of secondary falling and fracture and facilitating communication between the team which lead to improve the patients’ self care practices and their quality of life.
The aim of this study was:
To assess self care practices and quality of life among post trochanteric surgery patients.
Materials and method:
Research design:
Descriptive research design was utilized to meet the aim of the present study.
Setting:
The present study was carried out at the inpatient orthopedic surgery departments and outpatient clinics of El-Hadara Orthopedic and Traumatology University Hospital.
Subjects:
Based on Epi info 7 program, a convenience sample of 70 adult patients post trochanteric surgery from both sexes were selected from the above mentioned settings according to the following criteria:
•Adults from 50-60 years old, 2nd day post surgery.
•Free from any other traumatic problems or chronic disorders as diabetes, cardiac or kidney disease.
•Able to communicate.
•Willing to participate
Tools of the study:
In order to fulfill the aim of the study, three tools were used for data collection.
Tool I: Biosociodemographic characteristic
This tool was developed by the researcher after thorough review of relevant literatures. It was divided into two parts:
A- Sociodemographic data such as; age, sex, level of education, occupation, place of residence, marital status and socioeconomic status.
B- Fracture related items such as; diagnosis, date of fracture, admission date, mechanism of injury, type of fracture, name and date of operation and discharge date.
Tool II: Post trochanteric fracture patients’ self care practices (PTFSCPs)
This tool was developed by the researcher based on review of relevant literature. It included two parts:
Part I: Activity of Daily Living (ADLs) such as personal hygiene, bathing, toileting, dressing, grooming, eating, mobility and locomotion.
Part II: Instrumental Activity of Daily Living (IADLs) such as shopping, food preparation, housekeeping activity, laundry, mode of transportation and responsibility for own medications. Tool III: The World Health Organization Quality of Life BREF (WHOQOL-BREF)
This tool was adopted from The World Health Organization 2004 and was updated in 2005 then in 2014. It was translated into Arabic language by the researcher. The WHOQOL-BREF included a 26-item which used to assess health related quality of life and consisted of four domains: (1) Physical health, (2) Psychological health, (3) Social relationships domain and (4) Environmental health domain.
Data collection:
A convenience sample of seventy adult patients post trochanteric surgery who met the inclusion criteria were interviewed individually for 30-45 minutes.
Every patient was interviewed at the inpatient unit during the first 48 hours post surgery in which Tool I was used to collect bio-socio-demographic data. After patient‟s discharge and based on previous telephone call arrangement, every patient was interviewed at the outpatient clinics during their follow up period after 2 weeks and after one month (4 weeks) in which Tool II and Tool III was used to assess self care activities and health related quality of life. Data collection was initiated covering a period of 9 months from July 2018 to March 2019.
The main results of the study:
•The majority of the studied patients (78.6%) were in the age group of (58-60) years.
•Less than two third of the studied patients (61.4%) were females.
•Illiterate patients and housewives formed around one third of the studied patients (32.9%).
Nearly half of the studied patients (51.4%) were married and the majority of them (71.4%) were lived in urban area.
Patients with low socioeconomic level represented the highest percent (61.4%).
•Less than three quarter of studied patients (74.3%) had trochanteric fracture as a result fall and more than half of them (51.4%) had stable fracture.
•More than one third (35.7%) of them were hospitalized from 5 to 7 days before performing their trochanteric surgery
•Regarding ADLs, all of the patients (100.0%) had complete dependency in self care practice in their first follow up period (two weeks post surgery) and 92.5% of them had complete dependency in their second follow up period (one month post surgery)
•In relation to IADLs, all of the patients (100.0%) had complete dependency in self care practices in the first and second follow up periods except in relation to medications‟ responsibility (80.0%) of them had partial dependency in first follow up and (44.3%) of them had complete independency in self care practices in second follow up.
•The majority of the patients (78.6%, 75.7%) respectively had poor total quality of life at first follow up period (two weeks post surgery) as well as at the second follow up period (one month post surgery)
•There was statistically significant correlation between both patients’ self care practices and their educational level and patients’ QOL and their level of education in the second follow up (one month post surgery) (p= 0.001, 0.001) respectively.
•There was statistically significant correlation between patients’ self care practices and the mechanism of injury in the second follow up period (one month post surgery) (p= 0.012)
•There was statistically significant correlation between patients’ self care practices and duration of hospital stay before surgery in the 2nd follow up period (one month post surgery) (p= 0.018).
•There was statistically significant correlation between patients’ QOL and their age at first and second follow up periods (two weeks and one month post surgery) (p= 0.002, 0.009) respectively.
•There was statistically significant correlation between patients’ QOL and their marital status in the first follow up (two weeks post surgery) (p= 0.004).
•There was statistically significant correlation between patients’ self care practices and their QOL.
The main recommendations are:
1. Rehabilitation program on the patients’ self care practices and their quality of life post trochanteric surgery should be established and implemented.
2. Manual guideline to nurses working with trochanteric fracture patients about recent update in post trochanteric surgery management and rehabilitation.
3. A colored illustrated booklet should be available and distributed to each patient with trochanteric fracture about self care rehabilitation program.