Harnessing psychological resilience in hip fracture recovery: The overlooked role of sense of coherence

Table 2 Sense of coherence-informed micro-bundle embedded across orthogeriatric touchpoints

Touchpoint	Primary aim [comprehensibility-manageability-meaningfulness (the three components of the Sense of Coherence framework)]	Responsible role(s)	Core actions/scripts	Escalation triggers	electronic health record documentation
Admission	Comprehensibility	Nurse	One-page care timeline; teach-back of expectations	High Hospital Anxiety and Depression Scale scores; delirium risk flags	Checklist completion; patient understanding recorded
Postoperative days 1 and 2	Manageability	Physiotherapist; nurse	Specific, measurable, achievable, relevant, and time-bound (framework for goal setting) goals; graded mobilization; brief pain-coping (breathing, reappraisal)	Uncontrolled pain; non-progress in mobilization	Daily goal tracking; barriers noted
Early physiotherapy	Manageability + meaningfulness	Physiotherapist; psych/social work	Progressive activity plan; values-based reframing; micro-acts	Low engagement; mood deterioration	Session notes with goal attainment scaling
Discharge education	Comprehensibility + meaningfulness	Nurse; psych/social work	Frequently asked questions sheet; warning signs; community resources; narrative “next steps”	Incomplete self-management plan	Discharge checklist; referrals logged

Psych/social work: Psychology or social work (clinical liaison roles within orthogeriatric care).