Related Experiment Video
Updated: Sep 20, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Psychological Factors Predicting Functional Ability and Participation After Hip Fracture
Orit Segev-Jacubovski1, Hagit Magen2, Adina Maeir3
1Orit Segev-Jacubovski, PhD, is Lecturer, Department of Occupational Therapy, Ariel University, Ariel, Israel, and Clalit Health Service, Tel Aviv, Israel; oritsj@ariel.ac.il.
Importance:
Positive psychological factors have been related to better outcomes among adults with various health conditions.
Objective:
To predict functional ability and participation in older adults who had experienced a hip fracture on the basis of data at admission to acute (inpatient) rehabilitation. We measured physical factors, as well as positive and negative psychological factors, at three time points.
Design:
Prospective and cross-sectional cohort study. Data collection occurred during admission, at discharge, and 6 mo after rehabilitation.
Setting:
Inpatient geriatric rehabilitation center and follow-up at home.
Participants:
Seventy-one older adults (M age = 78.58 yr, SD = 6.09) who had sustained a hip fracture because of a fall and who attended acute rehabilitation; 55 completed follow-up assessments 6 mo after discharge from rehabilitation.
Measures:
Participants completed the Adult Hope Scale, Life Orientation Test, Positive Affect Questionnaire, Geriatric Depression Scale (at admission only), hand-grip strength measures, Numeric Pain Rating Scale, and FIM® Motor domain (mFIM) before and after acute rehabilitation and after 6 mo. The Activity Card Sort (ACS) was administered only at follow-up. Outcome measures were the mFIM and ACS.
Results:
At 6-mo follow-up, functional ability was correlated more with optimism than with age, gender, or hand-grip strength measured at admission. Participation was predicted by age, the hope-agency component, and pain in walking at admission; however, the hope-agency component was only marginally significant. At discharge, functional ability was strongly predicted by age, hand-grip strength, and mFIM scores at admission.
Conclusions And Relevance:
Optimism and hope played a role in explaining rehabilitation outcomes at 6-mo follow-up. Occupational therapy evaluation should address positive psychological factors, and intervention should aim to strengthen these factors as powerful aids in older adults' recovery from hip fractures. What This Article Adds: This study reflects the philosophy of occupational therapy, which places great emphasis on the connection between clients' mind-body-spirit and their participation in daily life occupations.
