Factors related to activity limitations in a group of Cuban Americans before and after hip fracture.

BACKGROUND AND PURPOSE: Cuban Americans over the age of 50 years, like people from a number of other cultures, have been exposed to distinctive social and psychological aspects of their culture that may affect their recovery from a major health event. The purpose of this study was to determine factors related to activity limitations in a group of Cuban Americans recovering from hip fractures.

SUBJECTS: The subjects were 28 adults of Cuban-American origin with an average age of 79 years (SD=9, range=57-96) who were recovering from hip fracture. Subjects were followed for 2 months after discharge from a hospital-based inpatient rehabilitation facility.

METHODS: Subjects were interviewed at the time of discharge from the rehabilitation facility and 2 months after discharge, and they completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and a social support interview. Functional Independence Measure scores and information regarding rehabilitative care were obtained from the rehabilitation facility. Multilinear regression analysis was used to determine the factors related to activity limitations before and after hip fracture.

RESULTS: More premorbid activity limitations were related to poorer mental health status, older age, and male sex. More activity limitations at the time of discharge from the rehabilitation hospital were related to poorer mental health status prior to admission and partial or non-weight-bearing status after hip fracture. Older age and male sex were premorbid factors that appeared to relate to function after discharge. More activity limitations during the 2 months after discharge were related to the subjects reporting more social support in the form of physical assistance, less social support in the form of emotional assistance, less negative social support in the form of demand and criticism, status for weight bearing as tolerated at the time of discharge from the rehabilitation hospital, and older age.

DISCUSSION AND CONCLUSION: In this group of Cuban Americans, mental health status was related to more activity limitations prior to admission to the rehabilitation facility and early in the recovery process, but not later in the recovery process. Conversely, social support was related to activity limitations later in the recovery process, but not prior to admission or early in the recovery process. Physical therapists should be aware of the psychosocial determinants of activity limitations during the process of recovery from disease or trauma.