Digitally Enhanced Nursing Discharge Teaching Reduces Postinjury Symptoms in Older Adults With Limb Fractures: A Nonrandomized Controlled Trial

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Abstract
Background: Persistent postinjury symptoms such as pain, depressive symptoms, and reduced quality of life can impede rehabilitation and delay recovery in older adults with limb fractures. Digitally enhanced, nurse‐led discharge teaching presents a promising approach to address these challenges, yet its effectiveness in geriatric limb trauma remains underexplored. This study evaluated the effects of a digitally enhanced nursing discharge teaching program on pain intensity, depressive symptoms, and quality of life in older adults with limb fractures. Methods: A nonrandomized, single‐blind, parallel‐group controlled trial enrolled 90 older adults with limb fractures at a tertiary center from January 2023 to February 2024; 76 completed all assessments. The experimental group received nurse‐led discharge teaching using a teach‐back method and an interactive digital book, delivered in person three days before discharge and reinforced through telephone follow‐up over two weeks. The control group received standard discharge care. Quality of life was the primary outcome; depressive symptoms and pain intensity were secondary outcomes. Outcomes were measured at baseline, two weeks, and six weeks postdischarge. Generalized estimating equations were used to assess group‐by‐time interaction effects. Results: Of 76 completers (mean age: 69.25 ± 3.76 years; 81.6% female), attrition was nondifferential (seven per group, 15.6%). Compared to the control group at six weeks, the experimental group showed greater reductions in pain intensity ( B = −1.95, 95% CI: [‐2.90, −0.99], p < 0.001) and depressive symptoms ( B = −1.05, 95% CI: [‐1.68, −0.42], p = 0.001), and greater improvement in quality of life ( B = 12.50, 95% CI: [4.34, 20.66], p = 0.003). No significant between‐group differences were found at the two‐week follow‐up. Conclusion: Digitally enhanced, nurse‐led discharge teaching improved pain, depressive symptoms, and quality of life in older adults with limb fractures over a six‐week period. Although short‐term effects were limited, the intervention shows promise in enhancing recovery outcomes. Additional refinement and long‐term evaluation are required before it can be implemented more widely. Implications for Nursing Management: This study highlights the value of integrating digitally enhanced nursing discharge teaching into transitional care planning, which may improve post‐injury outcomes and support recovery management in older adult patients. Trial Registration: ClinicalTrials.gov identifier: NCT05176054
Funding Information
  • National Science and Technology Council (MOST111-2314-B037-023-1)

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