Psychosocial Factors Are Rarely the Focus of Rehabilitation After Hip Fracture: A Short Report of Routinely Collected Health Data.

BACKGROUND AND PURPOSE: Hip fracture is a serious and common injury affecting older adults with significant psychosocial impacts. However, there is little information available on the assessment and treatment of psychosocial impacts of hip fracture during rehabilitation. Our aim was to determine the extent to which psychosocial factors are: (1) incorporated into goal setting; and (2) assessment and treatment during rehabilitation after hip fracture. METHODS: A retrospective data audit of patients admitted to a community rehabilitation program with a primary diagnosis of hip fracture from 30 June 2022 to 30 June 2023 in Melbourne, Australia. Data were extracted from the assessment and treatment notes of physiotherapists and occupational therapists. RESULTS: One-hundred included patients (59% female, mean age 81 (SD 7) years) were admitted to the community rehabilitation program an average of 41 days (SD 29) after hip fracture. All patients consulted a physiotherapist, 23 an occupational therapist, 6 a dietitian and 3 a social worker. Overall, 3 of 100 patients had a goal that focused on psychosocial functioning and 21 had a goal with a psychosocial element. A total of 96 patients had a mental health screening, but of 17 who were assessed as being 'at risk', 9 (53%) patients did not receive any documented psychosocial management, including 5 (29%) who declined referrals for mental health services. Apart from those patients screened as 'at risk' a number of patients with clinical notes indicating psychosocial concerns were recorded as receiving education (n = 16) and encouragement (n = 9). DISCUSSION: Psychosocial aspects of goals, assessment and treatment are rarely the focus of management in rehabilitation after hip fracture. More attention is needed to assess and treat psychosocial factors as part of a multidisciplinary, holistic approach to rehabilitation after hip fracture.