International Journal of Orthopaedic and Trauma Nursing最新文献_第2页

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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引用次数: 0

Enhanced recovery pathways in orthopaedic and trauma care: Nursing at the centre of interdisciplinary innovation 加强骨科和创伤护理的恢复途径：跨学科创新中心的护理。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 DOI: 10.1016/j.ijotn.2025.101215

Thomas W. Wainwright , Paul McLiesh

引用次数: 0

Nurse-led intervention in deep vein thrombosis development following major orthopedic surgery: A quality improvement project 护士主导的骨科大手术后深静脉血栓形成的干预：一个质量改进项目

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-11-01 DOI: 10.1016/j.ijotn.2025.101238

Chunming Yuan , Hao Wen , Xianbo Wu , Xiaorong Mao , Michael Zychowicz

Background

Deep vein thrombosis (DVT) accounts for most of thrombotic events following major orthopedic surgery. The development of DVTs increases medical costs and affects patient outcomes. Evidence suggests that ankle exercise helps to prevent DVTs after orthopedic surgery.

Method

A quality improvement project employing a quasi-experimental study design was conducted at a tertiary specialized hospitalized setting from August 2023 to January 2024. The project implemented a nurse-led evidence-based ankle exercise practice among adult patients undergoing major orthopedic surgery, aimed at evaluating the implementation process outcomes including staff adherence and agreement to the practice, and assessing patient outcome for the impact of the practice in DVT development. Nurse adherence was assessed by chart review, nurse agreement was collected using a validated Chinese version Normalization Measure Development (NoMAD) survey tool, DVT rate obtained as patient outcome was calculated via hospital information system.

Results

Nurse adherence to the evidence-based ankle exercise practice was 83 %. There were varying levels of agreement based on specific aspects of the NoMAD survey tool (100 % coherence insights; 85 % cognitive participation; 83.8 % reflexive monitoring; 68.6 % collective action). The incidence of DVT declined after the intervention introduction from 6.5 % to 4.8 % (p = .681).

Conclusions

Through this nurse-led evidence-based ankle exercise practice, we identified nurses adhered to the working process, and the DVT rate decreased in major orthopedic surgery. Further, a more rigorous study with a larger sample size might be needed to confirm the effectiveness of the ankle exercise in preventing DVT on major orthopedic surgery.

深静脉血栓形成（DVT）是骨科大手术后血栓形成的主要原因。深静脉血栓的发展增加了医疗费用并影响了患者的预后。有证据表明踝关节运动有助于预防骨科手术后的深静脉血栓形成。方法采用准实验研究设计，于2023年8月至2024年1月在某三级专科医院实施质量改进项目。该项目在接受重大骨科手术的成年患者中实施了一项由护士主导的循证踝关节锻炼实践，旨在评估实施过程的结果，包括员工对实践的遵守和同意，并评估实践对深静脉血栓形成的影响。通过图表回顾评估护士依从性，使用经过验证的中文版标准化测量发展（NoMAD）调查工具收集护士同意，通过医院信息系统计算作为患者结局的DVT率。结果护士对循证踝关节运动训练的依从率为83%。基于NoMAD调查工具的具体方面，有不同程度的同意（100%的一致性见解；85%的认知参与；83.8%的反射性监测；68.6%的集体行动）。干预后DVT的发生率从6.5%下降到4.8% （p = .681）。结论通过护士主导的循证踝关节锻炼实践，我们发现护士坚持工作流程，在骨科大手术中DVT发生率下降。此外，可能需要更严格、更大样本量的研究来证实踝关节运动在预防骨科大手术中DVT的有效性。

{"title":"Nurse-led intervention in deep vein thrombosis development following major orthopedic surgery: A quality improvement project","authors":"Chunming Yuan , Hao Wen , Xianbo Wu , Xiaorong Mao , Michael Zychowicz","doi":"10.1016/j.ijotn.2025.101238","DOIUrl":"10.1016/j.ijotn.2025.101238","url":null,"abstract":"<div><h3>Background</h3><div>Deep vein thrombosis (DVT) accounts for most of thrombotic events following major orthopedic surgery. The development of DVTs increases medical costs and affects patient outcomes. Evidence suggests that ankle exercise helps to prevent DVTs after orthopedic surgery.</div></div><div><h3>Method</h3><div>A quality improvement project employing a quasi-experimental study design was conducted at a tertiary specialized hospitalized setting from August 2023 to January 2024. The project implemented a nurse-led evidence-based ankle exercise practice among adult patients undergoing major orthopedic surgery, aimed at evaluating the implementation process outcomes including staff adherence and agreement to the practice, and assessing patient outcome for the impact of the practice in DVT development. Nurse adherence was assessed by chart review, nurse agreement was collected using a validated Chinese version Normalization Measure Development (NoMAD) survey tool, DVT rate obtained as patient outcome was calculated via hospital information system.</div></div><div><h3>Results</h3><div>Nurse adherence to the evidence-based ankle exercise practice was 83 %. There were varying levels of agreement based on specific aspects of the NoMAD survey tool (100 % coherence insights; 85 % cognitive participation; 83.8 % reflexive monitoring; 68.6 % collective action). The incidence of DVT declined after the intervention introduction from 6.5 % to 4.8 % (<em>p</em> = .681).</div></div><div><h3>Conclusions</h3><div>Through this nurse-led evidence-based ankle exercise practice, we identified nurses adhered to the working process, and the DVT rate decreased in major orthopedic surgery. Further, a more rigorous study with a larger sample size might be needed to confirm the effectiveness of the ankle exercise in preventing DVT on major orthopedic surgery.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101238"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465357","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

Seeing the patient beyond the fracture; the shared language of pain and recovery. 看到骨折后的病人；共同的痛苦和恢复的语言。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-10-28 DOI: 10.1016/j.ijotn.2025.101240

Charlotte Myhre Jensen, Charlotte Abrahamsen

引用次数: 0

Factors influencing and predicting the trajectory of care dependence among older hip fracture patients after total hip arthroplasty: a longitudinal study 影响和预测老年髋部骨折患者全髋关节置换术后护理依赖轨迹的因素：一项纵向研究。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-09-26 DOI: 10.1016/j.ijotn.2025.101236

Lu Wang , Zhuoqing Wu , Hong Zhou , Yanrui Ren

Objective

This study aimed to describe the development trajectory of care dependence in elderly total hip arthroplasty patients over a one-year survival period, identify heterogeneous care dependence trajectories, analyze the factors influencing the different underlying characteristics, further explore their predictors, and construct nomograms for prediction.

Methods

This study was conducted in three tertiary hospitals, 210 elderly patients over 60 who underwent total hip arthroplasty completed a one-year follow-up. Clinical evaluation and data collection were performed at surgical hospitalization and 1,6 and 12 months postoperatively. Latent growth mixed models(LGMM) were performed to explore the trajectories of change in patients' care dependence and identify heterogeneous trajectories. The multivariate logistic regression model was used to determine their predictors, and a nomogram was further constructed based on the predictors.

Results

The LGMM identified four classes of care dependency trajectories:“high dependency”,“dependency rising”,“dependency relief”,and“dependency decreasing”. The first two were referred to as “high-risk care dependency group” and the latter two were”low-risk care dependency group”. Regression analyses revealed age, education levels,comorbidity, postoperative complications, and whether to use an analgesic pump were independent predictors of heterogeneous care dependence trajectories, and a nomogram was constructed based on these predictors.

Conclusions

Older total hip arthroplasty patients have different heterogeneous trajectories of care dependency during one-year postoperative survival. Therefore, early assessment to predict the occurrence of heterogeneous trajectories of care dependency is important to improve the prognosis of elderly total hip arthroplasty patients and to help them return to independent living as soon as possible.

目的：本研究旨在描述老年全髋关节置换术患者一年生存期内护理依赖的发展轨迹，识别异质性护理依赖轨迹，分析影响不同潜在特征的因素，进一步探索其预测因子，构建预测图。方法：本研究在三所三级医院对210例60岁以上行全髋关节置换术的老年患者进行了为期一年的随访。在手术住院及术后1、6、12个月进行临床评价和资料收集。使用潜在生长混合模型（LGMM）来探索患者护理依赖的变化轨迹，并识别异质性轨迹。采用多元逻辑回归模型确定其预测因子，并基于预测因子构建nomogram。结果：LGMM识别出4类护理依赖轨迹：“高依赖”、“依赖上升”、“依赖缓解”和“依赖减少”。前两组称为“高风险护理依赖组”，后两组称为“低风险护理依赖组”。回归分析显示，年龄、教育程度、合并症、术后并发症和是否使用镇痛泵是异质性护理依赖轨迹的独立预测因素，并基于这些预测因素构建了nomogram。结论：老年全髋关节置换术患者在术后一年的生存期有不同的护理依赖轨迹。因此，早期评估预测异质性护理依赖轨迹的发生，对于改善老年全髋关节置换术患者的预后，帮助其尽快恢复独立生活具有重要意义。

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引用次数: 0

Risk factors for postoperative delirium in hip fractures in the elderly 老年人髋部骨折术后谵妄的危险因素分析

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-09-24 DOI: 10.1016/j.ijotn.2025.101235

Hui Gao , Kai Zheng , Hongxia Zhu , Yaozeng Xu , Xiaolan Feng

Purpose

To identify the risk factors for postoperative delirium (POD) in elderly patients with hip fracture and to examine the interrelationships among these factors.

Methods

Data of 210 elderly patients (≥65 years) who underwent surgical treatment for hip fractures from Jan 2023 to Dec 2023 were retrospectively analyzed. The patients were divided into the POD group and non-POD group based on whether they developed POD. The univariate analysis and binary multiple logistic regression were performed to determine the pre-, intra- and postoperative risk factors related to POD. The study was reported following the STROBE checklist.

Results

Among 210 patients, 26 were diagnosed with POD, representing 12.4 % of the cohort. The average POD time was 1.62 ± 0.75 days postoperatively. The incidence of POD was highest on the first day after surgery. The univariate comparison showed that the age, atrial fibrillation ratio, stroke history ratio, preoperative CAM-CR score, postoperative transferred to ICU ratio was higher in POD group compared with non-POD group. The general anaesthesia ratio in non-POD group was higher than POD group. The multivariate logistic regression showed that preoperative CAM-CR ≥ 15 score, age ≥80 years, atrial fibrillation, stroke history, fracture-surgery interval ≥7 days and postoperative transferred to ICU were independent risk factors of POD.

Conclusion

The potential risk factors of POD for hip fractures in the elderly include age≥80 years, preoperative CAM-CR ≥ 15 score, atrial fibrillation, stroke history, fracture-surgery interval ≥7 days and postoperative transferred to ICU.

目的探讨老年髋部骨折患者术后谵妄的危险因素，并探讨这些因素之间的相互关系。方法回顾性分析2023年1月至2023年12月接受髋部骨折手术治疗的210例老年患者（≥65岁）的资料。根据是否发生POD分为POD组和非POD组。采用单因素分析和二元多元logistic回归确定与POD相关的术前、术中和术后危险因素。该研究按照STROBE检查表进行报告。结果在210例患者中，26例被诊断为POD，占队列的12.4%。术后平均POD时间为1.62±0.75 d。术后第1天POD发生率最高。单因素比较显示，POD组患者的年龄、房颤比率、卒中史比率、术前CAM-CR评分、术后转ICU比率均高于非POD组。非POD组全身麻醉比例高于POD组。多因素logistic回归分析显示，术前CAM-CR评分≥15分、年龄≥80岁、房颤、卒中史、骨折手术间隔≥7天、术后转至ICU是发生POD的独立危险因素。结论老年人髋部骨折发生POD的潜在危险因素包括：年龄≥80岁、术前CAM-CR评分≥15分、房颤、卒中史、骨折-手术间隔≥7天、术后转入ICU。

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引用次数: 0