International Journal of Orthopaedic and Trauma Nursing最新文献

Aims

In the early stage, we developed an intelligent measurement APP for diabetic foot ulcers, named Diabetic Foot Smart APP. This study aimed to validate the APP in the measurement of ulcer area for diabetic foot ulcer (DFU).

Methods

We selected 150 DFU images to measure the ulcer areas using three assessment tools: the Smart APP software package, the ruler method, and the gold standard Image J software, and compared the measurement results and measurement time of the three tools. The intra-rater and inter-rater reliability were described by Pearson correlation coefficient, intra-group correlation coefficient, and coefficient of variation.

Results

The Image J software showed a median ulcer area of 4.02 cm², with a mean measurement time of 66.37 ± 7.95 s. The ruler method showed a median ulcer area of 5.14 cm², with a mean measurement time of 171.47 ± 46.43 s. The APP software showed a median ulcer area of 3.70 cm², with a mean measurement time of 38.25 ± 6.81 s. There were significant differences between the ruler method and the golden standard Image J software (Z = −4.123, p < 0.05), but no significant difference between the APP software and the Image J software (Z = 1.103, p > 0.05). The APP software also showed good inter-rater reliability and intra-rater reliability, with both reaching 0.99.

Conclusion

The Diabetic Foot Smart APP is a fast and reliable measurement tool with high measurement accuracy that can be easily used in clinical practice for the measurement of ulcer areas of DFU.

Trial registration

Chinese clinical trial registration number: ChiCTR2100047210.

Objective

Primary aim; to determine the feasibility of implementation of the INTERMED Self-Assessment (IM-SA) in adult patients scheduled for total knee arthroplasty (TKA). Secondary aim; to measure biopsychosocial complexity, referral to psychiatry or psychology in cases of complexity and to gain insight into the relation between biopsychosocial complexity and length of stay (LOS), method of discharge (MOD) and polypharmacy.

Methods

A feasibility study was conducted with 76 participants in a general hospital in the Netherlands. Feasibility was determined by the number of completed questionnaires, time spent completing the questionnaire and the attitude of staff and patients towards the IM-SA.

A cut off point ≥19 on the IM-SA was used to determine the prevalence of biopsychosocial complexity. A case file study was performed to check if referral to psychiatry or psychology had taken place.

The Spearman's Rank Correlation Coefficient or Phi was used to determine if there was a relation between biopsychosocial complexity and LOS, MOD and polypharmacy.

Results

All participants completed the IM-SA. The average time spent completing the questionnaire was 11.46 min (SD 5.74). The attitude towards the IM-SA was positive.

The prevalence of biopsychosocial complexity was 11.84%. Referral to psychiatry or psychology did not take place.

There was no relation between complexity and LOS (Spearman's rho (r) = 0.079, p = 0.499, MOD (Phi = 0.169, p = 0.173) and polypharmacy (Phi = 0.007, p = 0.953).

Conclusion

Biopsychosocial complexity can be identified in TKA patients during the pre-operative phase by using the IM-SA. Implementation of the IM-SA in a Dutch general hospital is feasible.

Background

Low back pain is a prevalent issue worldwide, impacting all healthcare professionals, in particular nurses, and leading to disability.

Objective

This study aimed to explore the predictive contribution of demographic factors, the presence of LBP, and knowledge about LBP in forecasting the level of disability among nurses in Oman.

Method

A cross-sectional study was conducted using a paper-based questionnaire comprising two valid tools: the Low Back Pain Knowledge Questionnaire and the Oswestry Low Back Disability Questionnaire. A total of 236 nurses working in two tertiary hospitals in Oman participated in the study.

Result

The findings indicate that 66.8% of nurses had low back pain. The low back pain knowledge score was 13.81(SD 4.42). The mean disability score was 9.13 (SD 8.56), indicating mild disability. There is a negative significant association between low back pain knowledge (r = -0.24, p < .004) and disability level. The low back pain presence was also significantly associated with disability level (t (233) = 4.606, p < .001). The results of the regression indicated the two predictors (i.e., knowledge level and low back pain) explained 13 % of the variation in nurses’ disability level [F (3,230) = 11.447, p = .01].

Conclusion

Low back pain is prevalent among nurses in Oman, and it is associated with disability. Preventive strategies need to be implemented.

Introduction

Upper cervical spine fractures are commonplace in the elderly following low energy trauma. These injuries carry high mortality rates, similar to patients sustaining hip fractures. A key aspect affecting clinical outcome is effective management in the first 12 weeks following injury. This study aims to assess the understanding of healthcare staff that may be required to care for such patients.

Materials and methods

A survey was carried out over a single day at the UK's largest Spine Specialist referral centre (Salford Royal Foundation Trust, SRFT) assessing the understanding of healthcare staff of the term, ‘Collar with occipital extension’, by asking staff to identify the safe position of the neck when looking at clinical images of a model in a collar in various different neck positions. The participants demographics were then taken, including profession, grade, spinal/post graduate experience, if English is their first language and their understanding of the term ‘Collar with occipital extension’.

Results

102 participants were interviewed and the results showed almost half (45.1%) of participants selecting an incorrect hyperextended neck to be a safe position for conservative treatment and only 37.3% selecting the neutral position as satisfactory. The only positive predictors identified for those selective the neutral safe cervical spine alignment was if participants had >5 years of previous spinal experience (p = 0.0006) or if they understood the term ‘Collar with occipital extension’ to be describing the collar component (p = 0.000013) and not neck position.

Conclusion

Management of spinal injuries are classically poorly managed in non-spinal centres, possibly due to the lack of training and understanding within the spinal speciality. This study shows the importance of clearly communicating with referring hospitals exactly how to conservatively manage patients with high cervical injuries to best improve clinical outcome.

Background

Hand injuries are very complex and worrying in terms of hindering activities of daily living, functionality and self-care skills. Hand injuries are caused by traumatic events, resulting in a partial or complete loss. The focus of acute treatment is surgical replantation.

Aim

In this study, nursing care and nursing experiences of a patient who was replanted as a result of hand trauma were discussed in the light of the Roy Adaptation Model.

Case

The male patient admitted to the emergency room due to traumatic amputation was a 49-year-old farmer. He lost his hand to an agricultural tool while working the land and was taken to the hospital within 4 h. He was taken up for emergency surgery for replantation. He has a history of diabetes mellitus. Nursing follow-up and interventions were applied by evaluating the data according to four adaptation modes (physiological needs, self-concept, role function and interdependence) within the scope of the Roy Adaptation Model.

Conclusion

and Suggestions: Patients experience difficulties (loss of function, financial problems, loss of role, psychological traumas) due to disability after injury. Therefore, nurses should know the underlying physiological risks, complications, and interventions to recognize and respond to situations that cause the loss of the reattached limb. Nursing models can identify patients' needs and problems, prevent complications, provide quality care, and manage the process. This study discussed the postoperative nursing care of a patient based on Roy's Adaptation Model.

Introduction

Effective postoperative pain management is necessary to improve the outcomes of older adults undergoing total knee replacement (TKR). Discovering what registered nurses (RNs) need to know about pain management may be beneficial to improving the quality of care.

Aim

The study aimed to identify the information needed to develop pain management education for RNs caring for older adults undergoing TKR.

Methods

A qualitative descriptive design was used in this study. Three focus groups were conducted with 22 staff RNs with experience caring for older adults undergoing TKR at a supra-tertiary care hospital in Bangkok, Thailand; one focus group was conducted with five members of the hospital's nursing pain management committee. Data were analyzed using content analysis.

Results

Two themes relevant to pain assessment education were pain assessment and pain management. Subthemes of pain assessment included challenges in cognitively impaired older adults, inadequate knowledge and misconceptions, and re-assessing pain. Three subthemes of pain management were created, including knowledge of pain medication, new trends in pharmacological pain management and devices, and non-pharmacological pain management using cold compression.

Conclusions

RNs require current information about pain management to provide effective postoperative care for older adults undergoing TKR. The findings may be used in pain management education to update RNs’ knowledge of pain management.

Background

Arthritis is a chronic condition of the joints and taking medicine alone cannot be effective in getting better result as there is no cure of the disease. Understanding the condition and the steps necessary to limit the disease's progression increases the practice of self-care behaviours, which are crucial for halting the disease's progression and sustaining quality of life.

Objective

The study aimed to assess the effectiveness of a nurse led educational program on knowledge and self-care behavior among arthritis patients.

Methods

This study used a single group pre-test and post-test, pre-experimental research design and selected 210 study participants using a convenient sampling technique at OPD of Ortho and Medicine department, Nims Medical College and Hospital, Nims University, Rajasthan, Jaipur, India.After pretest, patients participated in a four session of nurse led educational program, then post test was conducted after three months.

Results

The result shows that there was significant improvement in knowledge and self-care behavior among arthritis patients after the supportive educational program (p = 0.001).

Conclusion

The nurse led educational program can be seen as useful aid in raising knowledge and self-care behavior for the management of disease among patients.

Background

Since patients may experience difficulties in their daily activities after total knee replacement surgery, the role of the caregiver is important in supporting the daily needs of the patients. Caregivers are involved in the day-to-day care activities of the patient during the recovery process, managing their symptoms and providing support. All these factors can affect the burden and stress of caregivers.

Methods

It was aimed to compare the caregiver burden and stress of caregivers of total knee replacement patients who were discharged on the same day of surgery and at a later point. Data were collected from 140 caregivers by using the Bakas Caregiving Outcomes Scale, Zarit Caregiving Burden Scale, and Stress Coping Styles Scale.

Results

There was no significant difference between on the same day of surgery discharge and later discharge in terms of care burden and stress of caregivers (p > 0.05). While the burden of care was mild to moderate (22.15 ± 13.76) on the same day of surgery discharge group, the burden of care in the later discharge group was very low (19.03 ± 13.65).

Conclusion

In order to reduce the care burden and stress levels of caregivers, it is important that nurses determine the problems related to caregiving and provide the necessary support.