International Journal of Orthopaedic and Trauma Nursing最新文献

Effect of surgical treatment on mental health, disability and quality of life in active military and law enforcement personnel with non-specific chronic low back pain: A retrospective study

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-22 DOI: 10.1016/j.ijotn.2025.101183

Christos Karampalis , Stavros Stamiris , Athanasios Sarridimitriou , Dimitrios Stamiris , Elissavet Anestiadou , Panagiotis Kakoulidis , Pavlos Sarafis , Christiana Chatzianestiadou , Pavlos Christodoulou , Vasileios Vrangalas , Maria Malliarou

Background

Military and law enforcement personnel face an increased risk of chronic low back pain (CLBP), yet evidence on the outcomes of surgical treatment in these high-risk groups remains limited. This study aims to evaluate the effect of spinal fusion on quality of life (QOL), disability, and mental health in military and law enforcement personnel with CLBP.

Methods

The study included 39 patients who underwent spinal fusion for CLBP. Quality of life, disability, and mental health were assessed using the 36-Item Short Form Survey (SF-36), Oswestry Disability Index (ODI), and Depression-Anxiety-Stress Scale (DASS-21), respectively. Patients completed the questionnaires preoperatively and two years postoperatively. The primary outcome was the change in scores after surgery. Subgroup analyses were conducted based on sex, marital status, education level, smoking, alcohol consumption, and employment sector.

Results

Significant improvements were observed in seven of eight SF-36 subscales: Physical Health Role Limitation (p = 0.005), Emotional Health Role Limitation (p = 0.008), Energy (p = 0.004), Emotional Well-Being (p = 0.006), Social Function (p = 0.004), Physical Pain (p < 0.001), and General Health (p = 0.005). Physical (p = 0.002) and mental health components (p = 0.002) also improved. ODI decreased significantly (p = 0.014). Finally, improvement was observed only for the stress subcategory of the DASS-21 (p = 0.033). In subgroup analysis, Married patients showed greater improvements in emotional health (p = 0.008), while patients with lower educational levels experienced greater relief in physical pain (p = 0.028) and functionality (p = 0.010).

Conclusions

Spinal fusion in military and law enforcement personnel with CLBP led to significant improvements in QOL and disability, though mental health benefits are more limited.

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引用次数: 0

Increasing primary care nurse practitioner student confidence in select therapeutic musculoskeletal injections: A pilot study

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-15 DOI: 10.1016/j.ijotn.2025.101182

Nancy G. Russell, Rita F. D’Aoust, Chakra Budhathoki, Brenda Douglass, Catherine Ling

Background

Musculoskeletal conditions are commonly seen in outpatient settings, where many advanced practice nurses (registered nurses with additional graduate education and training) are filling the gap of primary care provider shortages globally. Family nurse practitioners (FNPs) are the most common advanced practice nurse type in primary care settings in the U.S. Therapeutic injections are recommended in a variety of knee and shoulder musculoskeletal disorders to provide short to moderate term improvement, but are underutilized in primary care, due in part to lack of provider comfort and training. Literature is limited regarding primary care nurse practitioner student training on therapeutic musculoskeletal injections. The purpose of this project was to increase family nurse practitioner (FNP) student confidence in providing therapeutic subacromial bursae shoulder and knee joint corticosteroid injections.

Methods

A pre/post design was used to evaluate participant confidence in knowledge and skill performance before and after an in-person workshop intervention focused on subacromial bursae shoulder and knee joint therapeutic injections.

Results

Twenty-four graduate nursing students training to be FNPs in a Doctor of Nurse Practice (DNP) program at one school of nursing participated. All knowledge and skill confidence change scores were statistically significant (p < .001) after the intervention. Most participants reported they were more likely to perform an intra-articular knee and subacromial bursae shoulder injection after the intervention.

Conclusions

Therapeutic corticosteroid injections are an important skill for advanced practice nurses in primary care. An in-person, experiential procedure workshop can increase the confidence of FNP students in therapeutic subacromial bursae shoulder and knee joint corticosteroid injections.

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引用次数: 0

Healthcare professional's management of the risk for postoperative urinary retention in hip surgery patients – a qualitative interview study

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-11 DOI: 10.1016/j.ijotn.2025.101180

Ami Hommel , Nina Hummerdal , Lovisa Strålöga , Joan Ostaszkiewicz , Maria Hälleberg-Nyman

Background

Postoperative urine retention can lead to permanent bladder dysfunction. This occurs even though healthcare personnel can access evidence-based guidelines on avoiding urine bladder injuries related to care.

Aim

This study aimed to describe healthcare professionals’ experiences with, and strategies to avoid post-operative urinary retention among hip surgery patients.

Method

A descriptive qualitative study using telephone interviews, were conducted in April to June 2021, with 22 healthcare professionals (13 nurses, 7 nursing assistants and 2 occupational therapists) in 17 orthopaedic wards in Sweden. Qualitative content analysis of interview data was performed.

Results

Five categories were identified: “Knowledge about guidelines regarding bladder monitoring”, “Understanding of patients' prehospital bladder function influences healthcare professionals’ reasoning and actions”, “Strategies are applied to make it easier for the patients to empty their bladder”, “Indwelling catheter is used routinely” and “Short length of stay creates stress”.

Conclusion

To optimise safe patient bladder monitoring after hip surgery, health care professionals need to be more aware of the availability of guidelines about bladder monitoring to adopt consistent monitoring practices, and to have enough time to care for patients.

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引用次数: 0

Validity and reliability of the Italian version of painad for postoperative pain assessment in geriatric patients with proximal femur fractures

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-11 DOI: 10.1016/j.ijotn.2025.101181

Massimo Guasconi , Margherita Marchioni , Melania Miedico , Alessia Brusca , Giulia Guarnaccia , Marina Bolzoni , Pietro Maniscalco , Corrado Ciatti , Antonio Bonacaro , Andrea Contini , Fabrizio Quattrini

Background

Pain assessment is essential in nursing care. The Numerical Rating Scale (NRS) is widely used but may not fully capture pain's multidimensional nature. The Pain Assessment in Advanced Dementia (PAINAD) scale is reliable for assessing pain in cognitively impaired patients. This study aims to evaluate the validity of the Italian version of PAINAD (PAINAD-IT) for postoperative pain assessment in geriatric patients with femur fractures.

Methods

This study employs the PAINAD-IT, which was translated and validated for the Italian context by Costardi et al. (2007). Face and content validity (I-CVI and S-CVI) for non-cognitively impaired patients were evaluated by experts. Pain assessments were conducted at rest (T0) and during movement (T1). Convergent validity was tested using Spearman correlation, discriminant validity with the Wilcoxon test, and inter-rater reliability with Cohen's kappa. Sensitivity and specificity were calculated.

Results

I-CVIs were ≥0.90 and S-CVI was 0.96. 75 patients were included. Cohen's kappa was 0.918 at T0 and 0.881 at T1. Both PAINAD and NRS detected a significant increase in pain from T0 to T1 (Wilcoxon p < 0.001). Sensitivity was 26 % and specificity was 99 % for PAINAD-IT scores ≥3.

Conclusion

PAINAD showed strong reliability and correlation with NRS, effectively distinguishing between rest and pain stages, these results suggest that PAINAD-IT may be a useful tool for pain assessment in geriatric patients operated for femur fracture. PAINAD-IT scores ≥3 may suggest severe pain. Further multi-centre studies with larger sample sizes are needed to fully validate PAINAD-IT for postoperative pain assessment in geriatric patients with.

背景疼痛评估在护理工作中至关重要。数字评定量表（NRS）被广泛使用，但可能无法完全反映疼痛的多维性。晚期痴呆症患者疼痛评估（PAINAD）量表在评估认知障碍患者的疼痛方面是可靠的。本研究旨在评估意大利语版 PAINAD（PAINAD-IT）在老年股骨骨折患者术后疼痛评估中的有效性。专家对非认知障碍患者的面效度和内容效度（I-CVI 和 S-CVI）进行了评估。疼痛评估在静息（T0）和运动（T1）时进行。使用斯皮尔曼相关性检验了收敛有效性，使用 Wilcoxon 检验了判别有效性，使用 Cohen's kappa 检验了评分者之间的可靠性。结果 I-CVI 均≥0.90，S-CVI 为 0.96。共纳入 75 名患者。T0时的Cohen's kappa为0.918，T1时为0.881。PAINAD 和 NRS 均能检测到从 T0 到 T1 疼痛的显著增加（Wilcoxon p < 0.001）。PAINAD-IT 评分≥3 分的灵敏度为 26%，特异度为 99%。结论 PAINAD 显示出很强的可靠性和与 NRS 的相关性，能有效区分休息和疼痛阶段，这些结果表明 PAINAD-IT 可能是老年股骨骨折手术患者疼痛评估的有用工具。PAINAD-IT 评分≥3分可能提示严重疼痛。要全面验证 PAINAD-IT 在老年股骨骨折患者术后疼痛评估中的有效性，还需要进一步开展样本量更大的多中心研究。

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引用次数: 0

The impact of specialised orthopaedic surgical nurses on operating room time.

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-01 DOI: 10.1016/j.ijotn.2025.101179

Di Costa Doriana , El Motassime Alessandro , Mazzella Giovan Giuseppe , Alfano Massimo , Addei Rossana , Arras Domizia , Fontana Marika , El Ezzo Omar , Maccauro Giulio , Vitiello Raffaele

Objective

Proximal femur fractures (PFF) have been widely recognised as a significant social and health issue due to their costs and their impact on patient mortality, representing one of the most common types of fracture in the elderly population. The most commonly used procedures for this type of fracture are intramedullary nailing or endoprosthesis, depending on the fracture pattern. There is limited research on dedicated surgical teams in the fields of orthopedics surgery. The purpose of this study is to evaluate the importance of having a specialised surgical nurse and the impact this can have on surgical timings.

Methods

This study was conducted in a level - 2 trauma center. We evaluated all patients who underwent surgery at our hospital from January 1st, 2021, to January 1st, 2022. We divided the patients into two groups, based on the type of treatment performed, then further subdivided based on the presence or absence of a specialised surgical nurse in the operating room.

Results

A total of 167 patients were categorized into two groups: those treated with an intramedullary nail (n=72) and those receiving an endoprosthesis (n=95). Each group was further divided based on the presence or absence of a specialised surgical nurse. We noticed significantly shorter operative times in procedures assisted by specialised nurses: 55.37 min (σ 12.97) vs. 81 min (σ 32) for intramedullary nailing (p=0.0001) and 80.2 min (σ 27) vs. 91.48 min (σ 27) for endoprosthesis (p=0.04).

Conclusions

In conclusion, surgical time has a significant impact on elderly patients undergoing surgery for hip fractures. Therefore, a specialised team, including a specialist orthopedic nurse, which helps reduce operative time, is essential.

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引用次数: 0

Impact of self-management training on quality of life, medication adherence, and self-efficacy among rheumatoid arthritis patients

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-01 DOI: 10.1016/j.ijotn.2025.101178

Puvaneswari Kanagaraj

Introduction

Rheumatoid Arthritis(RA) can result in significant joint destruction and work disability which needs physical and psychosocial adjustment to deal with pain, and fatigue.

Methods

True experimental parallel arm design with a pre-test post-test wait-listed control group was used to assess the impact of self-management training on Quality of life, medication adherence and self-efficacy among patients with RA. Participants were randomly allocated to the study(70) or control(70)group by simple randomization by the researcher. The study group underwent a self-management training consisting of six sessions over a 12-week period, while the control group received routine care. Importantly, the research assistant responsible for outcome assessment remained blinded to the treatment allocation at 1st, 3rd and 5th month post intervention using Short form- 36, Compliance Questionnaire, Rheumatology and Arthritis self efficacy scale.

Results

The SMT led to significant improvements in QoL-physical components including Pain (p = 0.001, partial eta squared(η²) = 0.372) and General Health (p = 0.001, η² = 0.320). Significant between-group differences were observed for Pain (p = 0.007), while other measures showed no differences. Mental health components also improved significantly in the study group, particularly in Energy (p = 0.001, η² = 0.344). Medication adherence improved initially but stabilized over time. The study group showed significant improvements in self-efficacy for pain, function, and other symptoms (p < 0.009), with large effect sizes and sustained progress.

Conclusion

By empowering patients with knowledge, skills, and confidence to effectively manage their condition, such health educations can contribute significantly improve overall health outcomes.

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引用次数: 0

Discharge transition experience and nursing needs of elderly patients with hip fracture: A qualitative systematic review [Letter].

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-03-27 DOI: 10.1016/j.ijotn.2025.101177

Sari Luthfiyah, Triwiyanto Triwiyanto, Hery Sumasto, Mohammed Ismath

This letter addresses the article "Discharge Transition Experience and Nursing Needs of Elderly Patients with Hip Fracture: A Qualitative Systematic Review" by Chun Huang et al., published in the International Journal of Orthopaedic and Trauma Nursing. The review offers valuable insights into the discharge transition experiences and nursing needs of elderly patients recovering from hip fractures, emphasizing critical aspects of care, such as rehabilitation, emotional well-being, and coordinated discharge planning. However, the review has notable limitations, including its focus on studies from developed countries, exclusion of patients with significant cognitive impairments, and the absence of quantitative data on the effectiveness of nursing interventions. Future research should aim to include a broader range of patient populations, particularly those with cognitive impairments, and consider diverse healthcare systems. Incorporating mixed-methods research and digital health technologies could also enhance the understanding and management of discharge transitions. The letter concludes by appreciating the contributions of the original review and suggesting directions for further research to improve care for elderly hip fracture patients.

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引用次数: 0

Parents' and nurses’ experiences when children undergo limb lengthening treatment

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-03-19 DOI: 10.1016/j.ijotn.2025.101176

Anders Ringnér , Malin Ljung , Anna-Clara Rullander

引用次数: 0

Post-operative outcomes among knee osteoarthritis patients undergoing simultaneous bilateral total knee arthroplasty

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-03-04 DOI: 10.1016/j.ijotn.2025.101175

Dalathorn Wathsuleelanond, Phichpraorn Youngcharoen, Suchira Chaiviboontham

Background and objectives

Simultaneous bilateral total knee arthroplasty (SBTKA) can improve post-surgical outcomes and reduce complications and cost of care. This study aimed to compare: (a) pain intensity levels in patients undergoing SBTKA between and before discharge, and 6 weeks after surgery, and (b) activities of daily living (ADL) and quality of life between the pre-operative period and 6 weeks after surgery.

Material and methods

Forty patients who were scheduled for SBTKA at inpatient units in a university-affiliated hospital in Bangkok, Thailand were recruited on the first day of admission using the face-to-face method. The research instruments included a demographic questionnaire, the Numeric Rating Scale (NRS), and the Knee and Osteoarthritis Outcome Score (KOOS): ADL, and knee-related quality of life subscales. The data were analyzed using descriptive statistics, paired t-test, and Wilcoxon Signed Rank Test.

Results

The results showed that the pain intensity level at six weeks after surgery was statistically significantly reduced when comparing the pre-discharge from the hospital (p = 0.000). Patients had improvements in their ADL (p = 0.000) and their quality of life (p = 0.000) at six weeks after surgery compared to before surgery.

Conclusions

Patients who underwent SBTKA had clinical improvement in terms of pain intensity reduction and enhancement of their ADL and quality of life.

{"title":"Post-operative outcomes among knee osteoarthritis patients undergoing simultaneous bilateral total knee arthroplasty","authors":"Dalathorn Wathsuleelanond, Phichpraorn Youngcharoen, Suchira Chaiviboontham","doi":"10.1016/j.ijotn.2025.101175","DOIUrl":"10.1016/j.ijotn.2025.101175","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Simultaneous bilateral total knee arthroplasty (SBTKA) can improve post-surgical outcomes and reduce complications and cost of care. This study aimed to compare: (a) pain intensity levels in patients undergoing SBTKA between and before discharge, and 6 weeks after surgery, and (b) activities of daily living (ADL) and quality of life between the pre-operative period and 6 weeks after surgery.</div></div><div><h3>Material and methods</h3><div>Forty patients who were scheduled for SBTKA at inpatient units in a university-affiliated hospital in Bangkok, Thailand were recruited on the first day of admission using the face-to-face method. The research instruments included a demographic questionnaire, the Numeric Rating Scale (NRS), and the Knee and Osteoarthritis Outcome Score (KOOS): ADL, and knee-related quality of life subscales. The data were analyzed using descriptive statistics, paired <em>t</em>-test, and Wilcoxon Signed Rank Test.</div></div><div><h3>Results</h3><div>The results showed that the pain intensity level at six weeks after surgery was statistically significantly reduced when comparing the pre-discharge from the hospital (p = 0.000). Patients had improvements in their ADL (p = 0.000) and their quality of life (p = 0.000) at six weeks after surgery compared to before surgery.</div></div><div><h3>Conclusions</h3><div>Patients who underwent SBTKA had clinical improvement in terms of pain intensity reduction and enhancement of their ADL and quality of life.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101175"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A less invasive catheterization protocol for managing urinary retention in patients undergoing hip and knee arthroplasty: A prospective cohort study

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-02-27 DOI: 10.1016/j.ijotn.2025.101172

Keetie Kremers-van de Hei , Bob Evers , Lotte Weijers , Diederick Duijvesz , Berend Willem Schreurs , Sander Koeter

Background

Postoperative urinary retention is a frequently seen serious complication after surgery. After orthopaedic hip or knee arthroplasty the incidence is relatively high, between 30 and 50% in previous studies. Currently, there is no consensus on the indication for urinary catheterization and a uniform guideline is lacking. This prospective cohort study examined the safety of a modified catheterization protocol with a catheterization threshold of 800 ml instead of 400 ml (usual care) after elective joint arthroplasty using ultrasound bladder scans. The hypothesis was that the incidence of catheterization will be reduced without increasing urinary complications.

Method

We prospectively included 305 patients who were treated according to the local fast track arthroplasty protocol in which a modified catheterization protocol was used. Catheterization was only performed at a scan volume of 800 ml or more. Bladder contents were monitored preoperatively, immediately postoperatively and at outpatient follow-up. Urological scores and complications were monitored. The usual care control group was treated according to the usual care protocol with a threshold for catheterization of 400 ml, these results were published in a previous study.

Results

The incidence of catheterization for urinary retention was significantly lower in patients who were treated with the less invasive protocol than the usual care control group (11.1% versus 48.8%, p < 0.001). The rate of urologic complications was low using the new protocol (4% urinary tract infection and 0.3% pharmacological interventions).

Conclusion

The results of our study provide strong empirical support for modifying catheterization protocols after orthopaedic surgery. A less invasive protocol is safe, provides reduction in workload for nurses, is patient-friendly and reduces costs.

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引用次数: 0