International Journal of Orthopaedic and Trauma Nursing最新文献

Purpose: This narrative review investigates cardiovascular fitness in patients undergoing hip and knee replacement for osteoarthritis (OA), with a focus on changes in VO₂ max before and after surgery. VO₂ max is a key physiological marker of aerobic capacity that is associated with post-operative outcomes and long-term health. For nurses involved in orthopaedic care, understanding how VO₂ max is affected by surgery and rehabilitation can inform patient education, discharge planning, and postoperative recovery strategies.

Principal results: Patients scheduled for total knee or hip replacement commonly present with low preoperative VO₂ max compared to matched healthy controls. While some studies hypothesise that this is due to reduced physical activity, direct measurement of activity levels or multivariate adjustment was generally lacking. Postoperatively, structured rehabilitation programmes may lead to improvements in VO₂ max, although findings vary based on the type, intensity, and duration of the intervention. Low-frequency or home-based exercise showed small improvements, while more intensive programmes, such as high-intensity interval training, had greater effects. However, many studies excluded patients with common comorbidities, limiting generalisability.

Major conclusions: Hip and knee replacement surgery may provide a critical window for improving cardiovascular fitness, especially when accompanied by targeted rehabilitation. These findings have important implications for nursing practice. Nurses can play a pivotal role in promoting structured aerobic exercise, supporting use of wearable technologies, and ensuring recovery pathways address cardiorespiratory health alongside joint mobility. Further research is needed to determine optimal rehabilitation strategies, improve inclusivity in VO₂ assessment, and evaluate long-term outcomes in diverse patient populations.

Introduction: Foley catheterization is often performed at time of admission in patients suffering a hip fracture. Guidelines for catheter management are inconsistent and lack consideration of the patient experience. We aimed to compare pain and convenience with voiding, as well as complication rates (urinary tract infection (UTI), postoperative urinary retention (POUR), and surgical site infection (SSI)) of catheterized versus non-catheterized patients awaiting hip fracture surgery.

Methods: Patients admitted to a single tertiary care hospital with a hip fracture completed a 3-item questionnaire about their preoperative bladder management experience. The primary outcome was pain associated with catheterization versus non-catheterization. Secondary outcomes included rates of postoperative UTI, POUR and SSI.

Results: A total of 119 patients were included. Fifty-five (93.2%) catheterized patients found the catheter to be convenient and only 6 (10.2%) reported pain with catheter use. Conversely, 28 (46.7%) non-catheterized patients found it painful to move to the bathroom and 17 (28.3%) reported pain with urination. Catheterized patients had significantly less pain related to emptying their bladder than non-catheterized patients (0.90/10 vs 3.59/10, respectively; p < 0.001). The rate of UTI (18.6% catheterized vs 13.3% non-catheterized), POUR (6.8% catheterized vs 11.1% non-catheterized) and SSI (3.4% catheterized vs 1.7% non-catheterized) were similar between groups.

Conclusions: Preoperative catheter use was associated with less pain with voiding and greater satisfaction for patients awaiting hip fracture surgery, without increasing rates of postoperative UTI, POUR, or SSI. Guidelines for catheter use should consider the patient experience.

Level of evidence: II.

Background: Nurses knowledge of palliative care is to ensuring patient-centred care, however, palliative care for individuals with fragility hip fractures remains insufficiently understood and underdeveloped.

Objective: This study aimed to assess nurses' knowledge of the palliative care needs of people with hip fragility fractures.

Methods: Descriptive-correlational, cross-sectional study. Portuguese nurses providing care to patients with hip fractures were selected through an intentional sample (n = 312), from February to April 2025, through an online questionnaire. Analysis used descriptive and inferential statistics. Ethical assumptions assured.

Results: Of the 312 nurses, 83,3 % were female. Most held a nursing degree (75,0 %) but were not specialized (59,9 %). The majority worked in the inpatient orthopaedic (32,1 %) and lacked education (57,7 %) or experience in palliative care (86,2 %). In the sample, 60.2 % of participants reported sufficient and insufficient levels of knowledge, while 53.2 % reported similar perceptions of competence. Most participants had never referred a person to palliative care (79.8 %) nor provided care to a patient with a hip fragility fracture under a palliative care team (76.9 %). The nurses' global knowledge was considered sufficient, particularly about symptom control, teamwork and communication, however, it was superior to the mean in the family support category. Some variables had significant correlations with global knowledge: academic qualifications, professional category, practice time, experience and education in palliative care, self-knowledge, and self-competence.

Conclusions: Most nurses demonstrated sufficient knowledge of the palliative care needs of people with fragility hip fractures, highlighting the need for greater investment in education and training to enhance nursing care responses.