Understanding the role of social factors in recovery after hip fractures: A structured scoping review

Abstract

Poor recovery among older adults with hip fractures can occur despite successful surgical repair and rehabilitation, suggesting other factors might play a role in recovery, such as social factors. The aim of this scoping review was to provide an overview of the literature on the role of social factors in older adult's recovery after hip fracture. This review followed the York Framework and its modifications and recent reporting guidelines. Two independent researchers searched main medical databases (CINAHL, EMBASE, Medline, PsycINFO and the Cochrane libraries) from inception to June 2017, for studies investigating social factors and recovery post hip fracture. Studies were excluded if they were qualitative, perspective papers or if participants were < 65 years or they were not living in the community. We screened 2,503 unique abstracts in total and 19 studies fulfilled the inclusion criteria. Social factors investigated in the included studies were social support, socioeconomic factors and living arrangement. We classified outcomes in the studies into three subgroups: physical functional recovery, mortality and other outcomes (pain, hospital length of stay and quality of life). We found evidence that social support and socioeconomic factors (e.g. socioeconomic status) were significantly associated with an increase in functional recovery, a decrease in mortality and other outcomes, but conflicting evidence was found for the effect of one's living arrangement. Only two included studies were randomised controlled trials. To conclude, social factors, such as social support and socioeconomic status, affect physical functional recovery and mortality in older adults with hip fractures. However, this is an under researched area that lacks rigorously designed studies and would benefit from more studies with rigorous designs.

Spiritual coping strategies and quality of life in older adults who have sustained a hip fracture: A cross‐sectional survey

“…(2019) similarly report that social support is associated with better community reintegration and health‐related quality of life following a hip fracture. This is supported by the conclusions of Auias et al.’s (2019) scoping review that social support following a hip fracture is associated with better physical recovery and lower mortality.…”

Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: a randomized controlled trial

“… 26 Other studies evaluating HRQoL and function following any type of fracture have reported lower HRQoL scores among fracture patients with low socioeconomic status compared with high socioeconomic status. 27 , 28 …”

Survival After Hip Fracture: A Comparative Analysis Between a Private and a Public Health Center in Chile

“…The sample size ensures that the distribution of the type of fracture and ASA score should probably be comparable. Also, social factors linked to the lack of social equity (such as social support and socioeconomic status) affects survival after hip fracture; nevertheless, this area lacks rigorously designed studies that measure the real impact on mortality after hip fracture [ 29 ]. Another limitation in this study is that the PRH data from 2002 to 2012 were manually registered; from 2012 onwards, an electronic file system was used, and this could be a source of bias.…”