Quality of life and spiritual coping strategies in older adults who have sustained a fractured femur : a cross-sectional survey

Abstract

Background: Quality of life consists of physical, psychological, social and environmental dimensions. Femoral fractures are associated with declines in quality of life and complicated recovery in which patients rarely recover completely to prefracture health status. Spiritual coping strategies, consisting of religious and nonreligious factors can be used by patents to enhance their quality of life. Objectives: To investigate the relationship between quality of life and spiritual coping strategies in patients who have sustained a fractured femur and possible significant differences between subgroups of demographic characteristics. Design: A quantitative, retrospective, cross-sectional research design was used. Settings: Participants were sent questionnaires in their own private homes or longterm care institutions according to where they resided. Participants: Maltese speaking older adults over 65 years of age and who have sustained a fractured femur in 2015 were invited. An intermediary person identified eligible participants, resulting in 299 potential participants. Methods: Data was collected through questionnaires, consisting of the WHOQOLBREF questionnaire and the spiritual coping strategies scale. Questionnaires were sent to participants by post and returned via a self-addressed stamped envelope. Two reminders were sent to participants, three weeks apart. Results: The poorest quality of life was experienced in the physical and psychological domains. Demographic variables such as being over 80 years of age, being female, living in an elderly home, having poor mobility status, being in pain were related to significant declines in quality of life and less frequent use of spiritual coping strategies. Scores for quality of life and spiritual coping strategies were positively correlated together. The use of non-religious coping was the best predictor of quality of life following a fractured femur. Conclusions: A fractured femur had serious implications on participants’ quality of life which could be minimised by promoting the use of spiritual coping strategies, particularly non-religious coping strategies which focus on family and interpersonal relationships.