International Journal of Orthopaedic and Trauma Nursing最新文献

Bone health in an upper Midwestern health system: Years 2008–2015 中西部北部健康系统中的骨骼健康：2008-2015年。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-12-15 DOI: 10.1016/j.ijotn.2025.101255

Ana M. Fernandez , Claudia C. Ramjattan , Colleen M. Renier , Kristy K. Lundberg , Samantha Nelson , Erica Lake , Theo A. Woehrle , Morgan Brenholdt , Paul K. Kosmatka , Chodisha Chakrapani , Megan A. Schwalbe , Melissa L. Harry

Introduction

Osteoporosis, osteopenia, and low impact fractures have documented effects on morbidity and mortality. This study explores the prevalence of osteoporosis and osteopenia among United States patients referred for a DXA scan and profiles patients experiencing low impact hip fractures (LIHFs) in an Upper Midwestern program to improve treatment and prevent secondary fractures in these patients.

Methodology

This retrospective observational study analyzed data from an in-house osteoporosis program database, trauma registry, and electronic health records. A DXA scan cohort included patients aged ≥50 years with completed DXA scans from 1/1/2008-9/30/2015. A LIHF cohort included patients aged ≥65 years receiving LIHF care from 1/1/2008-6/30/2015. Analyses included descriptive statistics, binary logit-linked generalized estimating equations, and survival analyses comparing mortality outcomes.

Results

In total, 11,725 patients received a DXA scan during the study period, of whom 21.3 % had osteoporosis and 33.9 % had osteopenia. Of those with osteoporosis, 46.3 % were on osteoporosis medication six months after a DXA scan. Mortality rates were low in the DXA scan cohort. Of 1207 patients aged ≥65 years with LIHFs, 12.8 % received osteoporosis medication six months following the LIHF. The one-year mortality rate post-LIHF was 29.6 % across females and males. Mortality odds and hazards were significantly lower in those with DXA scans versus those with no DXA scan documented.

Conclusions

Opportunities to improve bone health management are achievable by enhancing recognition and treatment of patients at high risk for LIHFs, including those without prior DXA scans. Ongoing collaborative care supporting initiation of medication treatment following LIHFs is necessary.

骨质疏松、骨质减少和低冲击骨折对发病率和死亡率有文献记载。本研究探讨了在美国接受DXA扫描的患者中骨质疏松和骨质减少的患病率，并分析了中西部上部项目中经历低冲击髋部骨折（LIHFs）的患者，以改善治疗并预防这些患者的继发性骨折。方法：这项回顾性观察性研究分析了来自内部骨质疏松项目数据库、创伤登记和电子健康记录的数据。DXA扫描队列包括2008年1月1日至2015年9月30日完成DXA扫描的年龄≥50岁的患者。LIHF队列纳入2008年1月1日至2015年6月30日期间接受LIHF治疗的年龄≥65岁的患者。分析包括描述性统计、二元逻辑关联的广义估计方程和比较死亡率结果的生存分析。结果：在研究期间，总共有11725名患者接受了DXA扫描，其中21.3%患有骨质疏松症，33.9%患有骨质减少症。在骨质疏松患者中，46.3%的患者在DXA扫描后6个月接受了骨质疏松药物治疗。DXA扫描队列的死亡率较低。1207例年龄≥65岁的LIHF患者中，12.8%的患者在LIHF发生6个月后接受了骨质疏松药物治疗。在女性和男性中，lihf后一年的死亡率为29.6%。与未记录DXA扫描的患者相比，进行DXA扫描的患者的死亡率和风险显著降低。结论：通过加强对LIHFs高风险患者的识别和治疗，包括未进行DXA扫描的患者，可以实现改善骨健康管理的机会。持续的协作护理支持在LIHFs后开始药物治疗是必要的。

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引用次数: 0

A retrospective case series study evaluating the use of synthetic dermal matrix for complex wounds: the Hong Kong experience 评价合成真皮基质用于复杂伤口的回顾性病例系列研究：香港的经验。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-12-12 DOI: 10.1016/j.ijotn.2025.101253

Wing Wah Chau , Pok Man Fung , Wai Fung Kwong

Background

Partial-thickness skin grafts (PTSG) are the conventional method for definite wound closure in orthopaedics; however, synthetic dermal matrix have emerged as an alternative for complex wounds, particularly when vital structures, like tendon and bone, are exposed.

Objective

This case series evaluates the clinical outcomes, cost implications, and granulation capacity of synthetic dermal matrix compared to PTSG using case-based observations and literature comparisons.

Methods

Seven patients with complex wounds treated with synthetic dermal matrix at a public hospital in Hong Kong between December 2023 and May 2024 were followed until complete wound healing. Outcomes included healing time, 30-day wound size reduction, matrix integration after delamination, hospitalization duration, and vital structure coverage.

Results

Synthetic dermal matrix showed successful granulation in all cases with variable healing times (51–205 days). Granulation over bone, tendon, and joint was observed in 71.4 % of patients. No readmissions or hematoma formation occurred.

Conclusion

Synthetic dermal matrix is a safe and effective method for managing wounds with exposed vital structures and shows potential cost benefits over traditional PTSG. Further studies with larger samples are needed.

背景：部分厚度皮肤移植（PTSG）是骨科伤口愈合的常规方法；然而，合成真皮基质已经成为复杂伤口的替代品，特别是当重要结构，如肌腱和骨骼暴露时。目的：本病例系列通过病例观察和文献比较，评估合成真皮基质与PTSG的临床结果、成本影响和造粒能力。方法：于2023年12月至2024年5月在香港某公立医院接受人工真皮基质治疗的7例复杂创面患者，随访至创面完全愈合。结果包括愈合时间、30天创面缩小、脱层后基质整合、住院时间和重要结构覆盖。结果：合成真皮基质在不同愈合时间（51 ~ 205天）下均能成功形成肉芽。71.4%的患者出现骨、肌腱和关节肉芽肿。无再入院或血肿形成。结论：合成真皮基质是一种安全有效的治疗重要结构暴露创面的方法，与传统PTSG相比具有潜在的成本优势。需要更大样本的进一步研究。

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引用次数: 0

Occupational noise induced hearing loss in orthopaedic theatre nurses: Exposing the silent threat and outlining interventions to prevent it 骨科手术室护士职业性噪音引起的听力损失：揭示无声的威胁并概述预防措施

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-12-09 DOI: 10.1016/j.ijotn.2025.101254

Thomas Dean , Olivia Crannage

Excessive and prolonged exposure to loud noises can lead to an irreversible reduction in hearing known as noise induced hearing loss (NIHL). Orthopaedic theatre nurses spend a significant amount of their career surrounded by noisy orthopaedic theatre equipment, yet the risks posed to them by excessive occupational noise and the rates of NIHL in this group remain relatively unknown. Sound levels in orthopaedic theatres have been shown to exceed UK Health and Safety Executive action values with surgical instruments such as saws and rasping systems all exceeding 100 dB. Theatre nurses are therefore at risk of developing NIHL and multiple other complications associated with hearing loss, such as higher rates of loneliness and depression. Noisy theatre environments have also been shown to degrade communication, increase total errors and result in longer times to complete tasks, all leading to reductions in patient safety.

This practice development article aims to raise awareness of occupational NIHL and empower theatre nurses to implement protective interventions for their hearing. The article outlines a range of measures to reduce excessive noise exposure to theatre staff and proposes the implementation of a nurse-led ‘noise-safe theatre’. These recommendations encourage the use of engineering and administrative controls in combination with NIHL education and PPE within theatres to improve safety for both staff and patients.

过度和长时间暴露在嘈杂的噪音中会导致听力的不可逆转的下降，称为噪音性听力损失（NIHL）。骨科手术室护士在其职业生涯中大部分时间都被嘈杂的骨科手术室设备所包围，然而过度的职业噪音给他们带来的风险以及这一群体中NIHL的发生率仍然相对未知。骨科手术室的声音水平已被证明超过英国健康与安全执行局的行动值，手术器械如锯和磨砂系统均超过100分贝。因此，手术室护士面临着患NIHL和与听力损失相关的多种其他并发症的风险，例如更高的孤独感和抑郁率。嘈杂的手术室环境也被证明会降低沟通，增加总错误，并导致完成任务的时间更长，所有这些都会降低患者的安全性。这篇实践发展文章旨在提高对职业NIHL的认识，并授权剧院护士实施听力保护干预措施。文章概述了一系列措施，以减少对剧院工作人员的过度噪音，并建议实施护士领导的“噪音安全剧院”。这些建议鼓励在手术室内结合NIHL教育和个人防护装备使用工程和行政控制措施，以提高工作人员和患者的安全性。

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引用次数: 0

Exploring patient perspectives of younger adults with complications after internal fixation of femoral neck fractures: A qualitative study 探讨年轻成人股骨颈骨折内固定术后并发症的患者观点：一项定性研究

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-26 DOI: 10.1016/j.ijotn.2025.101252

Michaela Manalili Hansen , Per Hviid Gundtoft , Maiken Stilling , Ming Ding , Bjarke Viberg , Charlotte Abrahamsen

Introduction

Internal fixation is the recommended treatment for femoral neck fractures in younger adults, as it preserves the native hip joint. However, high failure rates and suboptimal outcomes following internal fixation persist. While there is substantial research on the experiences of older adults with femoral neck fractures, the perspectives of younger adults with complications following internal fixation remain largely underexplored. This study aims to examine the lived experiences of younger adults who underwent secondary surgery after internal fixation of a femoral neck fracture, with focus on the period between the initial fixation and the subsequent operation.

Methods

This qualitative, exploratory study utilizes semi-structured interviews with younger adults who underwent secondary surgery due to complications following internal fixation of a femoral neck fracture. Participants were purposively sampled from three hospitals in Denmark. Interviews were conducted 2–4 weeks post-secondary surgery, transcribed verbatim, and analyzed using Malterud's Systematic Text Condensation.

Results

Eight participants (median age 61, range 38–69 years) were included. Analysis identified four overarching themes: (1) physical impact, (2) psychosocial and identity disruption, (3) healthcare and information gaps, and (4) coping and future outlook. Alarmingly, more participants reported losing the will to live, even expressing suicidal thoughts during this period.

Conclusion

This study highlights the profound physical, psychological, and social consequences of complications following femoral neck fractures in younger adults. The findings emphasize the need for clear communication and individualized, age-appropriate, and long-term rehabilitation that integrates physical and psychological support. Tailored care pathways are essential to improve recovery and quality of life.

内固定是年轻人股骨颈骨折的推荐治疗方法，因为它保留了原有的髋关节。然而，高失败率和内固定后的次优结果仍然存在。虽然对老年人股骨颈骨折的经验进行了大量研究，但对年轻人内固定术后并发症的研究仍在很大程度上不足。本研究旨在探讨年轻成人股骨颈骨折内固定后接受二次手术的生活经历，重点关注首次固定和后续手术之间的时间。方法：本定性、探索性研究采用半结构化访谈，对因股骨颈骨折内固定术后并发症而接受二次手术的年轻人进行访谈。参与者有目的地从丹麦的三家医院取样。访谈在二次手术后2-4周进行，逐字转录，并使用Malterud的系统性文本浓缩进行分析。结果纳入8例受试者，中位年龄61岁，年龄范围38 ~ 69岁。分析确定了四个总体主题：(1)身体影响；(2)社会心理和身份破坏；(3)医疗保健和信息差距；(4)应对和未来展望。令人担忧的是，更多的参与者报告说，在这段时间里，他们失去了活下去的意愿，甚至表达了自杀的想法。结论：本研究强调了年轻人股骨颈骨折并发症对身体、心理和社会的深远影响。研究结果强调需要明确的沟通和个性化的、适合年龄的、长期的康复，包括身体和心理支持。量身定制的护理途径对于改善康复和生活质量至关重要。

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引用次数: 0

Analysis of latent profiles of healthy promotion lifestyles and their influencing factors in women at high risk of primary osteoporosis 原发性骨质疏松高危妇女促进健康生活方式的潜在特征及其影响因素分析

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-25 DOI: 10.1016/j.ijotn.2025.101251

Xinyu Li , Siwu Tian , Zeng Yu , Hongyun Li , Baoqin Wu

Background

A health-promoting lifestyle involves increasing health awareness and actively adopting healthier habits. For women with osteopenia, becoming more aware of osteoporosis prevention and taking positive preventive actions can effectively improve health outcomes.

Aims

This study employed latent profile analysis (LPA) to assess the potential categories of healthy lifestyle promotion for women at high risk of primary osteoporosis. It aimed to identify high-risk subgroups, analyze differences and influencing factors among these groups, and offer evidence-based guidance for clinical nursing practice.

Methods

From December 2024 to July 2025, women were recruited using convenience sampling from endocrine outpatient departments and physical examination centers at two Grade A tertiary hospitals in Guiyang City. Data collection followed the planned time frame, and only eligible samples were included. Latent profile analysis was performed with Mplus 8.3, and univariate and multiple logistic regression analyses were conducted using SPSS 27.0.

Results

A total of 340 valid questionnaires were analyzed. Participants were categorized into three latent profiles: the low self-management—ineffective health behaviors group (28.8 %), the moderate self-management—average health behaviors group (45.3 %), and the high self-management—favorable health behaviors group (25.9 %).

Conclusion

These findings highlight disparities in the adoption of healthy lifestyles among women at high risk of primary osteoporosis. In clinical practice, nurses help patients with low health management recognize and overcome cognitive biases, use healthcare resources appropriately, and understand the importance of bone health. For patients with moderate health management, the can suggest exercise in addition to calcium supplementation. For those with high self-management, nurses can support their social networks to help maintain healthy behaviors over time.

促进健康的生活方式包括提高健康意识和积极养成更健康的习惯。对于骨质减少的女性，提高骨质疏松预防意识，采取积极的预防措施，可以有效改善健康状况。目的：本研究采用潜在特征分析（LPA）评估原发性骨质疏松症高危女性健康生活方式促进的潜在类别。旨在识别高危亚群，分析各高危亚群的差异及影响因素，为临床护理实践提供循证指导。方法于2024年12月至2025年7月，在贵阳市两所三级甲等医院内分泌门诊和体检中心采用方便抽样方法招募女性。数据收集遵循计划的时间框架，只纳入符合条件的样本。使用Mplus 8.3软件进行潜在分析，使用SPSS 27.0软件进行单因素和多元logistic回归分析。结果共回收有效问卷340份。参与者被划分为三个潜在特征：低自我管理-无效健康行为组（28.8%）、中等自我管理-平均健康行为组（45.3%）和高自我管理-良好健康行为组（25.9%）。结论这些发现突出了原发性骨质疏松症高危妇女在健康生活方式方面的差异。在临床实践中，护士帮助低健康管理患者认识和克服认知偏见，合理使用医疗资源，了解骨骼健康的重要性。对于健康管理适度的患者，他们可以建议在补充钙的同时进行锻炼。对于那些自我管理能力强的人，护士可以支持他们的社交网络，帮助他们长期保持健康的行为。

{"title":"Analysis of latent profiles of healthy promotion lifestyles and their influencing factors in women at high risk of primary osteoporosis","authors":"Xinyu Li , Siwu Tian , Zeng Yu , Hongyun Li , Baoqin Wu","doi":"10.1016/j.ijotn.2025.101251","DOIUrl":"10.1016/j.ijotn.2025.101251","url":null,"abstract":"<div><h3>Background</h3><div>A health-promoting lifestyle involves increasing health awareness and actively adopting healthier habits. For women with osteopenia, becoming more aware of osteoporosis prevention and taking positive preventive actions can effectively improve health outcomes.</div></div><div><h3>Aims</h3><div>This study employed latent profile analysis (LPA) to assess the potential categories of healthy lifestyle promotion for women at high risk of primary osteoporosis. It aimed to identify high-risk subgroups, analyze differences and influencing factors among these groups, and offer evidence-based guidance for clinical nursing practice.</div></div><div><h3>Methods</h3><div>From December 2024 to July 2025, women were recruited using convenience sampling from endocrine outpatient departments and physical examination centers at two Grade A tertiary hospitals in Guiyang City. Data collection followed the planned time frame, and only eligible samples were included. Latent profile analysis was performed with <em>Mplus 8.3</em>, and univariate and multiple logistic regression analyses were conducted using <em>SPSS 27.0</em>.</div></div><div><h3>Results</h3><div>A total of 340 valid questionnaires were analyzed. Participants were categorized into three latent profiles: the low self-management—ineffective health behaviors group (28.8 %), the moderate self-management—average health behaviors group (45.3 %), and the high self-management—favorable health behaviors group (25.9 %).</div></div><div><h3>Conclusion</h3><div>These findings highlight disparities in the adoption of healthy lifestyles among women at high risk of primary osteoporosis. In clinical practice, nurses help patients with low health management recognize and overcome cognitive biases, use healthcare resources appropriately, and understand the importance of bone health. For patients with moderate health management, the can suggest exercise in addition to calcium supplementation. For those with high self-management, nurses can support their social networks to help maintain healthy behaviors over time.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"60 ","pages":"Article 101251"},"PeriodicalIF":2.1,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to "Nurses' knowledge about palliative care needs of people with fragility hip fractures: a cross-sectional study" [Int. J. Orthopaedic Trauma Nurs. 59 (2025) 101242]. “护士对脆性髋部骨折患者姑息治疗需求的了解：一项横断面研究”的勘误表[j]。[j].中华骨科杂志，2015(5):357 - 357。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-24 DOI: 10.1016/j.ijotn.2025.101244

Sara Gomes, Ivo Paiva, Isabel Moreira, Andrèa Marques

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.

背景：护士对姑息治疗的了解是为了确保以患者为中心的护理，然而，对脆性髋部骨折患者的姑息治疗仍然缺乏充分的了解和发展。目的：本研究旨在评估护士对髋部脆性骨折患者姑息治疗需求的了解程度。方法：描述性相关、横断面研究。从2025年2月至4月，通过在线问卷调查，通过有意抽样（n = 312）选择为髋部骨折患者提供护理的葡萄牙护士。分析采用描述性统计和推断性统计。道德假设得到了保证。结果：312名护士中，女性占83.3%。大多数人拥有护理学位（75.0%），但没有专科学位（59.9%）。大多数在住院骨科工作（32.1%），缺乏教育（57.7%）或姑息治疗经验（86.2%）。在样本中，60.2%的参与者报告了足够和不足的知识水平，而53.2%的参与者报告了类似的能力感知。大多数参与者从未将患者转介到姑息治疗（79.8%），也没有在姑息治疗团队下为髋部脆性骨折患者提供护理（76.9%）。护士在症状控制、团队合作和沟通方面的整体知识被认为是足够的，但在家庭支持方面的知识优于平均水平。一些变量与全球知识显著相关：学历、专业类别、执业时间、姑息治疗经验和教育程度、自我知识和自我能力。结论：大多数护士对脆性髋部骨折患者的姑息治疗需求有足够的了解，这表明需要加大对教育和培训的投资，以加强护理响应。

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引用次数: 0

Nurses' knowledge about palliative care needs of people with fragility hip fractures: a cross-sectional study 护士对脆性髋部骨折患者姑息治疗需求的了解：一项横断面研究

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 DOI: 10.1016/j.ijotn.2025.101242

Sara Gomes , Ivo Paiva , Isabel Moreira , Andréa Marques

引用次数: 0

Pediatric critical care admission after scoliosis surgery in children with underlying conditions: requirements, evolution and comparison with healthy children 儿童脊柱侧凸手术后有潜在疾病的儿童重症监护住院：要求、演变及与健康儿童的比较

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 DOI: 10.1016/j.ijotn.2025.101239

Marta Cabrero Hernández , Alberto García-Salido , Inés Leoz-Gordillo , Gema de Lama Caro-Patón , José Luis Unzueta-Roch , Rosa María Egea-Gámez , Rafael González-Díaz , Montserrat Nieto-Moro

Aims

Research on postoperative care in pediatric intensive care units (PICU) for children with pre-existing medical conditions undergoing scoliosis surgery is limited. This study aims to describe their postoperative course and compare it with healthy children.

Methods

A descriptive, observational, and retrospective study conducted in PICU. Done through medical record review.

Results

Sixty patients included, 33 females (age of 13.6 ± 3.9 years). Among them, 44 had pre-existing medical conditions. The median PICU stay was two days (interquartile range, IQR, 1.25–4 days). Healthy patients experienced shorter stay (1.56 ± 0.81 days versus 8.84 ± 24.3 days, p = 0.01). Vasoactive drugs were only required in patients with underlying conditions (p = 0.027). Only one patient with IS required invasive mechanical ventilation (1/15, p = 0.047), and no deaths were reported.

Conclusions

In our study, children with an underlying condition needed more complex and prolonged PICU care. These findings could facilitate the prediction of postoperative needs in such patients.

Level of evidence

level IV, case series.

目的：在儿童重症监护病房（PICU）对已有疾病的儿童进行脊柱侧凸手术的术后护理研究是有限的。本研究旨在描述其术后病程，并与健康儿童进行比较。方法：在PICU进行描述性、观察性和回顾性研究。通过医疗记录审查完成的结果：60例患者中，女性33例，年龄13.6±3.9岁。其中44人之前就有疾病。PICU的中位住院时间为2天（四分位间距，IQR， 1.25-4天）。健康患者住院时间较短（1.56±0.81 d vs 8.84±24.3 d, p = 0.01）。只有有基础疾病的患者才需要血管活性药物（p = 0.027）。只有1例IS患者需要有创机械通气（1/15,p = 0.047），无死亡报告。结论：在我们的研究中，有潜在疾病的儿童需要更复杂和更长时间的PICU护理。这些发现有助于预测此类患者的术后需求。证据等级：四级，案例系列。

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引用次数: 0

Learning to assess the fall risk in clinical nursing education: an interpretative study 临床护理教育中评估跌倒风险的学习：一项解释性研究。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 DOI: 10.1016/j.ijotn.2025.101241

Ana Rita Pedrosa , Maria dos Anjos Dixe , Luís Sousa , Rogério Ferreira , Cristina Marques-Vieira , Andréa Marques , Cristina Lavareda Baixinho

Background

Falls are a complex problem for the health and quality of life of older persons. Risk assessment is important for identifying people at risk and planning preventive measures. Few studies have focused on how health professionals learn to assess this risk.

Objective

The aim of this study was to explore how nursing undergraduate students learn to assess fall risk in older adults/people during their hospital-based clinical practice.

Methods

This qualitative study was conducted within an interpretive paradigm. The focus group was selected as the method to address the research question: How do nursing students learn to assess of fall risk in the older population during clinical practice? The participants were students enrolled in a Bachelor of Nursing program. To support data organization and enhance analytic rigor, qualitative data analysis software (WebQDA®) was employed.

Results

Fifteen students participated in two focus groups. The analysis identified three main categories: (i) risk factors assessed; (ii) risk assessment; and (iii) learning to manage fall risk in clinical practice. Students reported that nursing supervisors primarily emphasized physical factors, mobility, and cognitive status. The findings also highlighted a gap between the assessment and the implementation of individualized interventions, as well as the difficulty in converting records into preventive actions and risk management.

Conclusions

Nursing students learn to assess fall risk primarily through observation of clinical practices and the influence of supervisors, although they do not always understand the instrumental basis or the correlation between risk and intervention. The results indicate the need to strengthen the training of professionals and students.

背景：跌倒是影响老年人健康和生活质量的一个复杂问题。风险评估对于识别风险人群和规划预防措施非常重要。很少有研究关注卫生专业人员如何学会评估这种风险。目的：本研究的目的是探讨护理本科学生在医院临床实践中如何学习评估老年人/人群的跌倒风险。方法：本定性研究在解释范式下进行。选择焦点小组作为解决研究问题的方法：护理学生如何在临床实践中学习评估老年人群的跌倒风险？参与者是参加护理学士课程的学生。为了支持数据组织和提高分析的严谨性，采用了定性数据分析软件（WebQDA®）。结果：15名学生参加了两个焦点小组。分析确定了三个主要类别：(i)评估的风险因素；（ii）风险评估；（三）学习在临床实践中管理跌倒风险。学生报告说，护理主管主要强调身体因素、活动能力和认知状况。调查结果还强调了评估和实施个性化干预措施之间的差距，以及将记录转化为预防行动和风险管理的困难。结论：护生主要通过观察临床实践和导师的影响来学习评估跌倒风险，尽管他们并不总是理解工具基础或风险与干预之间的相关性。结果表明，需要加强对专业人员和学生的培训。

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引用次数: 0

Impact of the family-centered empowerment model on postoperative recovery and self-care in patients undergoing unicompartmental knee arthroplasty 以家庭为中心的授权模式对单室膝关节置换术患者术后恢复和自我护理的影响

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 DOI: 10.1016/j.ijotn.2025.101243

Xueqing Song, Weitao Jiao, Huanhuan Liu, Hanyu Bai, Ping Fu, Meiyue Zhang, Boya Sun, Yumeng Zhang, Xue Wang

This prospective cohort study evaluated the Family-Centered Empowerment Model (FCEM) for enhancing recovery in 154 unicompartmental knee arthroplasty (UKA) patients (70 FCEM vs. 84 traditional care). The FCEM group received structured family participation, education, and empowerment strategies, while controls received routine care. Outcomes (Knee Society Score [KSS], Exercise of Self-Care Agency [ESCA], 36-Item Short Form Health Survey [SF-36]) were assessed preoperatively and postoperatively. Both groups showed joint status improvement, but the FCEM group demonstrated significantly superior functional recovery at all follow-ups: KSS function scores were higher at 1 month (P < 0.0001), 3 months (P = 0.01), and 12 months (P = 0.02). ESCA scores significantly favored FCEM at 1 month (P < 0.0001) and 3 months (P < 0.0001). SF-36 scores were also significantly higher in the FCEM group at 3 months (P < 0.0001) and 12 months (P < 0.0001). FCEM is associated with improved functional outcomes and quality of life post-UKA, supporting its broader implementation.

本前瞻性队列研究评估了以家庭为中心的授权模式（FCEM）对154例单室膝关节置换术（UKA）患者的康复效果（70例FCEM vs 84例传统护理）。FCEM组接受结构化的家庭参与、教育和赋权策略，而对照组接受常规护理。术前、术后评估预后（膝关节社会评分[KSS]、自理能力锻炼[ESCA]、36项健康调查表[SF-36]）。两组均显示关节状态改善，但FCEM组在所有随访中均表现出明显优于FCEM组的功能恢复：KSS功能评分在1个月（P < 0.0001）、3个月（P = 0.01）和12个月（P = 0.02）时更高。ESCA评分在1个月（P < 0.0001）和3个月（P < 0.0001）时显著有利于FCEM。FCEM组在3个月（P < 0.0001）和12个月（P < 0.0001）时SF-36评分也显著高于FCEM组。FCEM与uka后功能结果和生活质量的改善有关，支持其更广泛的实施。

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