International Journal of Orthopaedic and Trauma Nursing最新文献

英文中文

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

Specialised orthopaedic surgical nurses: Reducing operative time and improving outcomes in hip fracture surgery 骨科专科护士：缩短手术时间，提高髋部骨折手术效果。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-09-22 DOI: 10.1016/j.ijotn.2025.101233

Brijesh Sathian , Hanadi Al Hamad , Javed Iqbal , Syed Muhammad Ali

引用次数: 0

From surgery to struggle: Recovery journeys after periprosthetic knee fractures 从手术到挣扎：膝关节假体周围骨折后的康复之旅

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-09-22 DOI: 10.1016/j.ijotn.2025.101234

Javed Iqbal, Brijesh Sathian, Syed Muhammad Ali

引用次数: 0

Literature reviews – Impact of multidisciplinary teams on fracture care in older people 文献综述-多学科团队对老年人骨折护理的影响

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-09-11 DOI: 10.1016/j.ijotn.2025.101231

Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros

引用次数: 0

Application of a comprehensive clinical care pathway in patients undergoing total hip arthroplasty 综合临床护理路径在全髋关节置换术患者中的应用

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-09-08 DOI: 10.1016/j.ijotn.2025.101232

Yanfang Zhang, Ke Sun, Hui Li

Introduction

This study aims to design a comprehensive management plan for patients undergoing hip replacement surgery to determine whether it can reduce hospitalization days, lower hospitalization costs, reduce postoperative pain, and improve joint function.

Methods

We searched PubMed, Web of Science, Cochrane Library, China Knowledge Network, Wanfang Database, Wipu Database, and China Biomedical Literature Database to analyze the literature and draft the initial pathway based on clinical reality. The pathway was then refined through Delphi expert correspondence. In the validation phase, 126 patients were assigned to control and experimental groups. The pathway's effects were evaluated by assessing hospital stay duration, costs, joint function, kinesiophobia scores, highest postoperative pain scores, readiness for discharge, and satisfaction with follow-up.

Results

Patients using the pathway had shorter hospital stays and lower costs than controls. They also exhibited better postoperative kinesiophobia and joint function scores, and higher readiness for discharge and satisfaction with follow-up. However, no significant difference was observed in highest postoperative pain scores.

Conclusion

This pathway can reduce the length of hospital stay and costs for patients undergoing total hip arthroplasty. It also provides opportunities for early rehabilitation, improves postoperative joint function, reduces fear of movement, and enhances satisfaction with follow-up.

本研究旨在设计髋关节置换术患者的综合管理方案，以确定是否可以减少住院天数，降低住院费用，减轻术后疼痛，改善关节功能。方法检索PubMed、Web of Science、Cochrane图书馆、中国知识网、万方数据库、Wipu数据库、中国生物医学文献数据库，对文献进行分析，并结合临床实际拟定初步路径。然后通过德尔菲专家通信对该途径进行了改进。在验证阶段，126名患者被分为对照组和实验组。通过评估住院时间、费用、关节功能、运动恐惧症评分、最高术后疼痛评分、出院准备情况和随访满意度来评估该途径的效果。结果使用该途径的患者比对照组住院时间短，费用低。他们也表现出更好的术后运动恐惧症和关节功能评分，以及更高的出院准备和随访满意度。然而，术后最高疼痛评分无显著差异。结论该路径可减少全髋关节置换术患者的住院时间和费用。它还提供了早期康复的机会，改善术后关节功能，减少运动恐惧，提高随访满意度。

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引用次数: 0

The effect of aromatherapy massage with peppermint oil on functional impairments in patients with knee osteoarthritis 薄荷油香薰按摩对膝关节骨关节炎患者功能障碍的影响

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-08-29 DOI: 10.1016/j.ijotn.2025.101221

Zahra Momen Arani , Batool Zamani , Amir Mohammad Barati , Mohammadreza Zarei , Neda Mirbagher Ajorpaz

Background

Knee osteoarthritis (KOA) is a prevalent degenerative joint disorder that significantly impairs physical function and daily activities. While conventional treatments focus on symptom management, complementary therapies such as aromatherapy massage have gained attention for their potential benefits.

Objective

This study evaluates the effects of peppermint oil aromatherapy massage on functional impairments in KOA patients.

Methods

A randomized controlled trial was conducted on 120 KOA patients at Shahid Beheshti Hospital, Kashan, Iran at October 2024 to December 2024. Participants were randomly assigned to three groups: intervention (peppermint oil massage), placebo (paraffin oil massage), and control (no intervention). The intervention and placebo groups received biweekly 15-min knee massages for four weeks. Functional outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline, post-intervention, and one-month follow-up. Statistical analyses included chi-square, ANOVA, and repeated measures ANOVA.

Results

Baseline characteristics and KOOS subscale scores were comparable across groups (p > 0.05). The intervention group demonstrated significant improvements in pain reduction, symptom relief, and daily function over time (p < 0.001), while no significant changes were observed in the sports and recreation subscale (p > 0.05). ANOVA confirmed significant intergroup differences in KOOS subscales of pain, symptoms, and daily function at all time points (p < 0.05), except for sports/recreation and quality of life (p > 0.05).

Conclusion

Peppermint oil aromatherapy massage significantly alleviates KOA-related pain and functional impairment, enhancing daily activities and overall well-being. Given its non-invasive nature and ease of application, this intervention could be recommended as an adjunctive therapy for KOA management.

膝骨关节炎（KOA）是一种常见的退行性关节疾病，严重损害身体功能和日常活动。虽然传统疗法侧重于症状管理，但芳香疗法按摩等补充疗法因其潜在益处而受到关注。目的探讨薄荷油香薰按摩对KOA患者功能障碍的影响。方法对2024年10月至2024年12月在伊朗卡尚市Shahid Beheshti医院就诊的120例KOA患者进行随机对照试验。参与者被随机分为三组：干预组（薄荷油按摩）、安慰剂组（石蜡油按摩）和对照组（不干预）。干预组和安慰剂组每两周接受15分钟的膝关节按摩，持续四周。在基线、干预后和1个月随访时，使用膝关节损伤和骨关节炎结局评分（oos）评估功能结局。统计分析包括卡方分析、方差分析和重复测量方差分析。结果各组基线特征和kos分量表评分具有可比性（p > 0.05）。随着时间的推移，干预组在疼痛减轻、症状缓解和日常功能方面有显著改善（p < 0.001），而在运动和娱乐亚量表上没有观察到显著变化（p < 0.05）。方差分析证实，除运动/娱乐和生活质量外，所有时间点的kos亚量表疼痛、症状和日常功能组间差异显著（p < 0.05）。结论薄荷油香薰按摩可显著缓解koa相关疼痛和功能障碍，增强日常活动能力和整体幸福感。鉴于其无创性和易于应用，该干预措施可推荐作为KOA管理的辅助治疗。

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引用次数: 0

The effect of a nurse-led multicomponent intervention on sleep quality and delirium in orthopedic surgery patients: A randomized clinical trial 护士主导的多成分干预对骨科手术患者睡眠质量和谵妄的影响：一项随机临床试验

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-08-28 DOI: 10.1016/j.ijotn.2025.101222

Mansureh Sohrabi , Mohammad Gholami , Saeid Foroughi , Elahe Younesi , Yaser Mokhayeri

Background

Sleep disturbances and postoperative delirium (POD) impair recovery and adversely affect cognitive and physical outcomes among orthopedic trauma patients.

Objective

This study aimed to evaluate the effects of a nurse-led multicomponent intervention on POD, sleep quality, and quality measures among orthopedic surgical patients.

Method

This double-blind randomized clinical trial was conducted on 96 orthopedic surgical patients who were assigned into intervention (n=48) and control (n=48) groups using stratified block randomization. The intervention group received a multicomponent care program including multimodal pharmacological pain management, music therapy, inspiratory muscle training (IMT), and a structured sleep enhancement protocol, initiated 24 hours before surgery and continued for 48 hours postoperatively. The control group received standard care. Sleep quality and POD were assessed using the richards-campbell sleep questionnaire (RCSQ) and the confusion assessment method (CAM), respectively. The data on length of hospital stay and 30-day mortality were collected through electronic health records and self-reports.

Results

The mean total sleep quality score and its subscales were significantly higher in the intervention group compared to the control group (P < 0.001). The average length of hospital stay was significantly shorter in the intervention group (P = 0.047). There were no statistically significant differences between the two groups regarding the incidence of POD or 30-day mortality (P > 0.05).

Conclusion

Results show, a perioperative multicomponent nurse-led intervention can effectively enhance sleep quality and reduce the length of hospital stay among orthopedic surgical patients. Nevertheless, it did not show a significant effect on delirium incidence or short-term mortality.

背景：在骨科创伤患者中，睡眠障碍和术后谵妄（POD）损害康复，并对认知和身体预后产生不利影响。目的评价护士主导的多组分干预对骨科手术患者POD、睡眠质量及质量指标的影响。方法采用分层块随机法将96例骨科手术患者随机分为干预组（n=48）和对照组（n=48）进行双盲临床试验。干预组接受多组分护理方案，包括多模式药物疼痛管理、音乐治疗、吸气肌训练（IMT）和结构化睡眠增强方案，从术前24小时开始，持续至术后48小时。对照组接受标准治疗。分别采用richards-campbell睡眠问卷（RCSQ）和困惑评估法（CAM）对睡眠质量和POD进行评估。通过电子健康记录和自我报告收集住院时间和30天死亡率数据。结果干预组的平均总睡眠质量评分及其分量表均显著高于对照组（P < 0.001）。干预组患者平均住院时间明显缩短（P = 0.047）。两组POD发生率和30天死亡率比较，差异无统计学意义（P > 0.05）。结论围手术期护士主导的多要素干预可有效提高骨科患者的睡眠质量，缩短住院时间。然而，它并没有显示出对谵妄发生率或短期死亡率的显著影响。

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引用次数: 0

Corrigendum to “Impact of obesity on outcomes after total hip and knee replacement: A study on hospital length of stay and readmission rates in NHS Scotland” [Int. J. Orthopaedic Trauma Nurs. 58 (2025) 101216] “肥胖对全髋关节和膝关节置换术后预后的影响：苏格兰NHS住院时间和再入院率的研究”[Int.][j] .骨科创伤护理，58(2025)101216。

IF 2.1 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-08-26 DOI: 10.1016/j.ijotn.2025.101218

Wissem Tafat , David McDonald , Marcin Budka , Thomas W. Wainwright

引用次数: 0

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