Digitally Enhanced Nursing Discharge Teaching Program for Geriatric Trauma

The Effects of a Digitally Enhanced Nursing Discharge Teaching Program on Post-Injury Symptoms in Older Adults With Limb Fractures: A Quasi-Experimental Study

This quasi-experimental study evaluates the effectiveness of a digitally enhanced nursing discharge teaching program for older adults recovering from limb fractures. As patients transition from the acute trauma ward to home care, they often face significant challenges managing pain, psychological distress, and daily functioning. This study compares a structured, digitally supported educational intervention against standard hospital discharge care. The primary goal is to determine if the digital program improves patients' pain intensity, depressive symptoms, and overall quality of life during the first six weeks post-discharge compared to routine care.

Study Overview

• Status: Completed
• Conditions: Trauma; Aging
• Intervention / Treatment: Other: Digitally Enhanced Nursing Discharge Teaching Program

Detailed Description

Geriatric trauma patients, specifically those suffering from limb fractures, experience a high risk of poor functional and psychological outcomes following hospital discharge. Standard discharge teaching is often constrained by the fast-paced nature of acute trauma wards, limiting patients' ability to retain critical recovery information. To address this, the current study implemented a digitally enhanced nursing discharge teaching program.

This study utilized a non-randomized, quasi-experimental design with two parallel arms: a contrast group receiving standard routine discharge care, and an experimental group receiving the digitally enhanced program. The digital intervention included interactive, multimedia educational content delivered prior to discharge, supplemented by structured telephone follow-ups by nursing staff to reinforce symptom management, mobility safety, and recovery strategies at home.

Participants were recruited continuously based on acute hospital admissions. The primary outcomes assessed were pain intensity (Numeric Pain Rating Scale), depressive symptoms (Geriatric Depression Scale-Short Form), and overall quality of life (WHOQOL). Data were collected at three distinct time points: baseline (prior to hospital discharge), two weeks post-discharge, and six weeks post-discharge. The study aims to evaluate the clinical efficacy of this digital transition model and its feasibility for integration into routine geriatric trauma care.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Kaohsiung City, Taiwan
    • Kaohsiung Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years to 74 years (Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• First-time patients with limb fracture as the primary diagnosis.
• Capable of independent mobility before the injury.
• Able to communicate in Mandarin.
• Willing to participate from hospital discharge to six weeks post-discharge.
• Able to use a smartphone and have internet access.
• A pain score greater than four on the Numeric Pain Rating Scale (NPRS).
• A depression score greater than four on the Geriatric Depression Scale Short Form (GDS-SF).

Exclusion Criteria:

• Were cognitively impaired.
• Suffered from cardiovascular, pulmonary, or cerebral insufficiency.
• Had a history of psychiatric or terminal illnesses.
• Had visual impairments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental group; Participants in this experimental arm receive the digitally enhanced nursing discharge teaching program. This includes interactive, multimedia educational content delivered prior to hospital discharge, followed by structured telephone follow-ups during the 6-week recovery period.	Other: Digitally Enhanced Nursing Discharge Teaching Program; A structured transitional care program utilizing interactive, multimedia digital content to teach pain management, psychological coping, and recovery strategies. The initial digital education provided in the acute ward is supplemented by scheduled telephone follow-up sessions conducted by nursing staff to reinforce the material and support patients in their home environment.
No Intervention: Contrast group; Participants in this contrast arm receive a standard pamphlet, routine hospital discharge care and standard verbal education prior to transitioning home.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The World Health Organization Quality of Life Questionnaire	The WHOQoOL-BREF will be used to measure quality of life. Six popular generic instruments of HRQOL are commonly used as disability outcome measures, some of them were developed later were tested trans-culturally in extensive research programs such as the WHOQoL-BREF. The WHOQoL-BREF is a 26-item scale that is measure along with four subscales including physical, psychological, social relationship and environment domains. Scores range from 1 to 5 with higher scores indicating higher quality of life. The reliability and validity of the Chinese WHOQoL-BREF have been tested in patients with traumatic injuries, but not in geriatric trauma. Thus, the Cronbach's alpha for this study will be retested.	Baseline (1 day prior to hospital discharge), 2 weeks post-discharge, and 6 weeks post-discharge.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Numeric Pain Rating Scale	The NPRS is a one-dimensional measure of pain intensity in adults. A NPRS has similar anchors at the extremes but offers numbers from 0 through 10. It is well known and broadly used scale in clinical settings. No further reliability and validity tests are needed.	Baseline (1 day prior to hospital discharge), 2 weeks post-discharge, and 6 weeks post-discharge.
The Geriatric Depression Scale Short Form	The GDS-SF is a 15-item scale used to identify depression in older adults. It is from the original GDS developed by Sheikh and Yesavage to examine the self-perceived emotions of older adults. The version will be used in this study is a validated Chinese that has been tested its reliability in geriatric older population in Taiwan. The GDS-SF features binary scores for a total score of 0-15. A higher score indicates a more severe of depression. In the GDS-SF, a score of 0 to 5 is normal, a score > 5 suggests depression, and a score ≥ 10 is almost indicative of depression. The Cronbach's alpha for this study will be retested.	Baseline (1 day prior to hospital discharge), 2 weeks post-discharge, and 6 weeks post-discharge.

Collaborators and Investigators

• Sponsor: Kaohsiung Medical University Chung-Ho Memorial Hospital
• Investigators: Principal Investigator: Bih-O Lee, PHD, Kaohsiung Medical University

Study record dates

Study Major Dates

• Study Start (Actual): January 2, 2023
• Primary Completion (Actual): February 29, 2024
• Study Completion (Actual): February 29, 2024

Study Registration Dates

• First Submitted: August 30, 2021
• First Submitted That Met QC Criteria: December 15, 2021
• First Posted (Actual): January 4, 2022

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 20, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: KMUHIRB- F(II)-20210057

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No