Effect of postoperative urinary retention in older patients with hip fracture on self-efficacy, resilience, and quality of life.

Background: Hip fracture (HF) is a major health problem for older patients. Postoperative urinary retention (POUR) is a common complication in HF patients. It extends the length of the hospital stay and affects the recovery of mobility. This study aims to explore the relationship between self-efficacy, resilience, and quality of life in older patients with HF after HF combined with POUR and to improve the rehabilitation plan for HF patients.

Methods: A retrospective case-control study was conducted to assess 221 older patients with HF who underwent surgery for the first time at the Department of Orthopedics, Xishan People's Hospital from June 2018 to June 2021. Of these, 111 patients were in the POUR group (Group A), and the remaining 110 patients were in the non-POUR group (Group B). Three months after the operation, a questionnaire was administered to assess the relationship between POUR and self-efficacy, resilience, and quality of life.

Results: Self-efficacy scores of Group A (23.52±3.18) were lower than those of Group B (27.23±2.40), and the difference was statistically significant (P<0.05). Except for self-improvement, subscores and total scores of all resilience measures in Group A were lower than those of Group B, and these differences were statistically significant (P<0.05). The scores of all quality of life measures of Group A were lower than those of Group B, and the differences were statistically significant except for role-emotional (RE) (P<0.05). The correlation analysis between self-efficacy and resilience in older patients with HF after the operation showed that self-efficacy was positively correlated with the total resilience score and the toughness optimism dimensions (P<0.01). Correlation analysis between self-efficacy and quality of life showed that self-efficacy was positively correlated with role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), and social functioning (SF) (P<0.01). Correlation analysis between resilience and quality of life showed that total resilience scores, toughness, and optimism were positively correlated with physical functioning (PF), RP, BP, GH, VT, and SF (P<0.05).

Conclusions: The combination of POUR after HF significantly reduces self-efficacy, resilience, and quality of life in older adults.