Pub Date : 2025-11-01Epub Date: 2025-10-22DOI: 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。
{"title":"Pediatric critical care admission after scoliosis surgery in children with underlying conditions: requirements, evolution and comparison with healthy children","authors":"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","doi":"10.1016/j.ijotn.2025.101239","DOIUrl":"10.1016/j.ijotn.2025.101239","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>A descriptive, observational, and retrospective study conducted in PICU. Done through medical record review.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>level IV, case series.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101239"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393910","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}
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.
{"title":"The effect of a nurse-led multicomponent intervention on sleep quality and delirium in orthopedic surgery patients: A randomized clinical trial","authors":"Mansureh Sohrabi , Mohammad Gholami , Saeid Foroughi , Elahe Younesi , Yaser Mokhayeri","doi":"10.1016/j.ijotn.2025.101222","DOIUrl":"10.1016/j.ijotn.2025.101222","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances and postoperative delirium (POD) impair recovery and adversely affect cognitive and physical outcomes among orthopedic trauma patients.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the effects of a nurse-led multicomponent intervention on POD, sleep quality, and quality measures among orthopedic surgical patients.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101222"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919786","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}
Pub Date : 2025-11-01Epub Date: 2025-09-26DOI: 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.
{"title":"Factors influencing and predicting the trajectory of care dependence among older hip fracture patients after total hip arthroplasty: a longitudinal study","authors":"Lu Wang , Zhuoqing Wu , Hong Zhou , Yanrui Ren","doi":"10.1016/j.ijotn.2025.101236","DOIUrl":"10.1016/j.ijotn.2025.101236","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101236"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208127","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}
Pub Date : 2025-11-01Epub Date: 2025-09-22DOI: 10.1016/j.ijotn.2025.101233
Brijesh Sathian , Hanadi Al Hamad , Javed Iqbal , Syed Muhammad Ali
{"title":"Specialised orthopaedic surgical nurses: Reducing operative time and improving outcomes in hip fracture surgery","authors":"Brijesh Sathian , Hanadi Al Hamad , Javed Iqbal , Syed Muhammad Ali","doi":"10.1016/j.ijotn.2025.101233","DOIUrl":"10.1016/j.ijotn.2025.101233","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101233"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259358","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}
Pub Date : 2025-11-01Epub Date: 2025-11-04DOI: 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.
{"title":"Learning to assess the fall risk in clinical nursing education: an interpretative study","authors":"Ana Rita Pedrosa , Maria dos Anjos Dixe , Luís Sousa , Rogério Ferreira , Cristina Marques-Vieira , Andréa Marques , Cristina Lavareda Baixinho","doi":"10.1016/j.ijotn.2025.101241","DOIUrl":"10.1016/j.ijotn.2025.101241","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>This qualitative study was conducted within an interpretive paradigm. The focus group was selected as the method to address the research question: <em>How do nursing students learn to assess of fall risk in the older population during clinical practice?</em> 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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101241"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507502","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}
Pub Date : 2025-11-01Epub Date: 2025-08-26DOI: 10.1016/j.ijotn.2025.101218
Wissem Tafat , David McDonald , Marcin Budka , Thomas W. Wainwright
{"title":"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]","authors":"Wissem Tafat , David McDonald , Marcin Budka , Thomas W. Wainwright","doi":"10.1016/j.ijotn.2025.101218","DOIUrl":"10.1016/j.ijotn.2025.101218","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101218"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902840","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}
Pub Date : 2025-11-01Epub Date: 2025-08-29DOI: 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.
{"title":"The effect of aromatherapy massage with peppermint oil on functional impairments in patients with knee osteoarthritis","authors":"Zahra Momen Arani , Batool Zamani , Amir Mohammad Barati , Mohammadreza Zarei , Neda Mirbagher Ajorpaz","doi":"10.1016/j.ijotn.2025.101221","DOIUrl":"10.1016/j.ijotn.2025.101221","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>This study evaluates the effects of peppermint oil aromatherapy massage on functional impairments in KOA patients.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101221"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010928","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}
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.
{"title":"Impact of the family-centered empowerment model on postoperative recovery and self-care in patients undergoing unicompartmental knee arthroplasty","authors":"Xueqing Song, Weitao Jiao, Huanhuan Liu, Hanyu Bai, Ping Fu, Meiyue Zhang, Boya Sun, Yumeng Zhang, Xue Wang","doi":"10.1016/j.ijotn.2025.101243","DOIUrl":"10.1016/j.ijotn.2025.101243","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101243"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519942","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}
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.
{"title":"Risk factors for postoperative delirium in hip fractures in the elderly","authors":"Hui Gao , Kai Zheng , Hongxia Zhu , Yaozeng Xu , Xiaolan Feng","doi":"10.1016/j.ijotn.2025.101235","DOIUrl":"10.1016/j.ijotn.2025.101235","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify the risk factors for postoperative delirium (POD) in elderly patients with hip fracture and to examine the interrelationships among these factors.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101235"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158244","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}
Pub Date : 2025-11-01Epub Date: 2025-09-08DOI: 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。
{"title":"Application of a comprehensive clinical care pathway in patients undergoing total hip arthroplasty","authors":"Yanfang Zhang, Ke Sun, Hui Li","doi":"10.1016/j.ijotn.2025.101232","DOIUrl":"10.1016/j.ijotn.2025.101232","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"59 ","pages":"Article 101232"},"PeriodicalIF":2.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050071","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}
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