Pub Date : 2023-12-04DOI: 10.1016/j.ijotn.2023.101074
Elin Saga , Ragnhild S. Falk , Pia C. Bing-Jonsson , Kirsti I. Skovdahl , Espen Lindholm
Introduction
Elderly with hip fractures present complex challenges. Effective pain management is crucial for recovery and quality of life. However, pain control can be difficult and requires customized care.
Methods
We conducted an unblinded, randomised controlled trial investigating the effects of ultrasound-guided femoral nerve block in patients with hip fracture performed by specially trained nurses (Group Nurse) compared to anaesthesiologists (Group Anaesthesiologist). The hypothesis was that a single shot ultrasound-guided femoral nerve block would result in a total summarized lower dynamic numeric rating scale score for pain intensity during the first 120 min after admission for patients in Group Nurse compared to Group Anaesthesiologist measured in five timepoints. The primary outcome was measured by a cumulative numeric rating scale score for dynamic pain (with flexion of the hip until maximum 30° from bed surface) during the first 120 min after admission to the emergency department.
Results
From February 2020 to June 2021, 263 patients were screened, of which 42 (16.0%) consented and were randomly allocated; 21 in each arm. The primary outcome was not different between groups (p = 0.24), and displayed no substantial superiority of specially trained nurses over anaesthesiologist. No complications or adverse effects were observed in either group. The use of systemic analgesics and the development of delirium was similar between the two groups. In the Nurse Group, patients were administered their ultrasound-guided femoral nerve block earlier.
Conclusion
Our study did not demonstrate a statistically significant beneficial effect of specially trained nurses over anaesthesiologist on cumulative pain in performing ultrasound-guided femoral nerve blocks, while no side-effects/complications or adverse effects were observed in either group.
Clinicaltrial
The trial was registered on October 31, 2019 at Clinicaltrials.gov (NCT04145752).
{"title":"Nurse-led ultrasound-guided femoral nerve block: A randomised controlled trial of two different patient flow systems in an emergency department","authors":"Elin Saga , Ragnhild S. Falk , Pia C. Bing-Jonsson , Kirsti I. Skovdahl , Espen Lindholm","doi":"10.1016/j.ijotn.2023.101074","DOIUrl":"https://doi.org/10.1016/j.ijotn.2023.101074","url":null,"abstract":"<div><h3>Introduction</h3><p>Elderly with hip fractures present complex challenges. Effective pain management is crucial for recovery and quality of life. However, pain control can be difficult and requires customized care.</p></div><div><h3>Methods</h3><p>We conducted an unblinded, randomised controlled trial investigating the effects of ultrasound-guided femoral nerve block in patients with hip fracture performed by specially trained nurses (Group Nurse) compared to anaesthesiologists (Group Anaesthesiologist). The hypothesis was that a single shot ultrasound-guided femoral nerve block would result in a total summarized lower dynamic numeric rating scale score for pain intensity during the first 120 min after admission for patients in Group Nurse compared to Group Anaesthesiologist measured in five timepoints. The primary outcome was measured by a cumulative numeric rating scale score for dynamic pain (with flexion of the hip until maximum 30° from bed surface) during the first 120 min after admission to the emergency department.</p></div><div><h3>Results</h3><p>From February 2020 to June 2021, 263 patients were screened, of which 42 (16.0%) consented and were randomly allocated; 21 in each arm. The primary outcome was not different between groups (p = 0.24), and displayed no substantial superiority of specially trained nurses over anaesthesiologist. No complications or adverse effects were observed in either group. The use of systemic analgesics and the development of delirium was similar between the two groups. In the Nurse Group, patients were administered their ultrasound-guided femoral nerve block earlier.</p></div><div><h3>Conclusion</h3><p>Our study did not demonstrate a statistically significant beneficial effect of specially trained nurses over anaesthesiologist on cumulative pain in performing ultrasound-guided femoral nerve blocks, while no side-effects/complications or adverse effects were observed in either group.</p></div><div><h3>Clinicaltrial</h3><p>The trial was registered on October 31, 2019 at <span>Clinicaltrials.gov</span><svg><path></path></svg> (<span>NCT04145752</span><svg><path></path></svg>).</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"52 ","pages":"Article 101074"},"PeriodicalIF":1.4,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878124123000783/pdfft?md5=470a20272fc985c38110ca3f0054e365&pid=1-s2.0-S1878124123000783-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138550217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-21DOI: 10.1016/j.ijotn.2023.101066
Sally Ann Martens , Terry A. Badger
Background
School-aged children enter an essential phase of psychosocial development in which they begin to form their self-concept. Having a negative self-concept has a direct relationship on the gradual evolution of a child's personality which can influence academic and career success, peer interactions and relationships, generativity and life satisfaction and meaning. There is limited research examining self-concept in children with congenital upper limb differences.
Objectives
Describe self-concept in school-aged children with congenital upper limb differences (CULD).
Methods
In this convergent mixed methods study, we used the Piers Harris Children's Self-Concept Scale (PHCSCS) and modified photovoice methodology to explore self-concept in school aged children with CULD. The quantitative results from the PHCSCS were merged with the qualitative findings from the 63 photographs and 63 written descriptions provided by nine children.
Results
Mean self-concept was 51.22 (±10.43). Mean domain scores: behavioral adjustment 52 (±8.19), freedom from anxiety 48.56 (±10.42), happiness and satisfaction 49.44 (±10.73), intellectual and school status 54.78 (±10.31), and social acceptance 49.89 (±8.64). Nine participants described five themes of self-concept: emotions, sense of accomplishments, positive view of oneself and one's physical body, hobbies, and a sense of connection. Children defined their self-concept through expressions of self-efficacy, self-image, and social identity.
Implications
Results created a more comprehensive description of self-concept, and expanded understanding of the social identity of school-aged children with congenital upper limb difference. Future research is needed to examine the relationships between self-efficacy, self-image, and social identity to develop interventions promoting healthy self-concept development.
{"title":"SELF-CONCEPT development of school-aged children with congenital upper limb differences: A mixed-methods study","authors":"Sally Ann Martens , Terry A. Badger","doi":"10.1016/j.ijotn.2023.101066","DOIUrl":"https://doi.org/10.1016/j.ijotn.2023.101066","url":null,"abstract":"<div><h3>Background</h3><p>School-aged children enter an essential phase of psychosocial development in which they begin to form their self-concept. Having a negative self-concept has a direct relationship on the gradual evolution of a child's personality which can influence academic and career success, peer interactions and relationships, generativity and life satisfaction and meaning. There is limited research examining self-concept in children with congenital upper limb differences.</p></div><div><h3>Objectives</h3><p>Describe self-concept in school-aged children with congenital upper limb differences (CULD).</p></div><div><h3>Methods</h3><p>In this convergent mixed methods study, we used the Piers Harris Children's Self-Concept Scale (PHCSCS) and modified photovoice methodology to explore self-concept in school aged children with CULD. The quantitative results from the PHCSCS were merged with the qualitative findings from the 63 photographs and 63 written descriptions provided by nine children.</p></div><div><h3>Results</h3><p>Mean self-concept was 51.22 (±10.43). Mean domain scores: behavioral adjustment 52 (±8.19), freedom from anxiety 48.56 (±10.42), happiness and satisfaction 49.44 (±10.73), intellectual and school status 54.78 (±10.31), and social acceptance 49.89 (±8.64). Nine participants described five themes of self-concept: emotions, sense of accomplishments, positive view of oneself and one's physical body, hobbies, and a sense of connection. Children defined their self-concept through expressions of self-efficacy, self-image, and social identity.</p></div><div><h3>Implications</h3><p>Results created a more comprehensive description of self-concept, and expanded understanding of the social identity of school-aged children with congenital upper limb difference. Future research is needed to examine the relationships between self-efficacy, self-image, and social identity to develop interventions promoting healthy self-concept development.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"52 ","pages":"Article 101066"},"PeriodicalIF":1.4,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480343","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 : 2023-11-08DOI: 10.1016/j.ijotn.2023.101063
Paula Rocha , Cristina Lavareda Baixinho , Andrea Marques , Maria Adriana Henriques
Background
Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge.
Objective
To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge.
Method
A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias.
Results
Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling.
Conclusions
In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.
{"title":"Safety-promoting interventions for the older person with hip fracture on returning home: A systematic review","authors":"Paula Rocha , Cristina Lavareda Baixinho , Andrea Marques , Maria Adriana Henriques","doi":"10.1016/j.ijotn.2023.101063","DOIUrl":"10.1016/j.ijotn.2023.101063","url":null,"abstract":"<div><h3>Background</h3><p>Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge.</p></div><div><h3>Objective</h3><p>To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge.</p></div><div><h3>Method</h3><p>A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias.</p></div><div><h3>Results</h3><p>Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling.</p></div><div><h3>Conclusions</h3><p>In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"52 ","pages":"Article 101063"},"PeriodicalIF":1.4,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878124123000679/pdfft?md5=2699f8f1a238a782d8a3c2e67205e3a6&pid=1-s2.0-S1878124123000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1016/j.ijotn.2023.101065
Mayuri Sivanathan, Clemens Rabes
Introduction
Elderly persons have an increased risk for negative health-related outcomes, including higher mortality rates. A centre for geriatric traumatology was established in a German-speaking Swiss hospital to provide more specialised, person-centred care and to lower negative health outcomes. Adaptations and changes in the patient pathway were made by implementing fast-track and person-centred care to better address individual needs.
Methods
The current patient pathway was analysed by an interprofessional and interdisciplinary geriatric traumatology expert team. The practice development methodology and the Person-Centred Practice Framework (PCP-Framework) were used throughout this engagement process. In consensus within the expert team, the sample was defined as elderly persons aged 65 years or older with suspected hip joint closed fractures. The focus was on three elements of “practice environment” from the PCP-Framework. These were: (1) supportive organisational systems; (2) the physical environment; (3) appropriate skill mix.
Results
Several adaptations and changes were made addressing the three elements of “practice environment”. These were for example: (1) use of specific assessments, shared decision-making; (2) proper and effective use of aids; (3) integration of Advanced Practice Nurses. The adaptations in the patient pathway were integrated into the standard operating procedures.
Conclusions
Through active engagement with the practice development methodology and the focus on person-centredness, the process of care for elderly persons was adapted. Thus, by addressing individual needs, fast-track and person-centred care in geriatric traumatology is provided. Further research is needed to evaluate and to verify implications in clinical practice.
{"title":"Fast-track and person-centred care in geriatric traumatology in a German-speaking Swiss hospital – A practice development project","authors":"Mayuri Sivanathan, Clemens Rabes","doi":"10.1016/j.ijotn.2023.101065","DOIUrl":"https://doi.org/10.1016/j.ijotn.2023.101065","url":null,"abstract":"<div><h3>Introduction</h3><p>Elderly persons have an increased risk for negative health-related outcomes, including higher mortality rates. A centre for geriatric traumatology was established in a German-speaking Swiss hospital to provide more specialised, person-centred care and to lower negative health outcomes. Adaptations and changes in the patient pathway were made by implementing fast-track and person-centred care to better address individual needs.</p></div><div><h3>Methods</h3><p>The current patient pathway was analysed by an interprofessional and interdisciplinary geriatric traumatology expert team. The practice development methodology and the Person-Centred Practice Framework (PCP-Framework) were used throughout this engagement process. In consensus within the expert team, the sample was defined as elderly persons aged 65 years or older with suspected hip joint closed fractures. The focus was on three elements of “practice environment” from the PCP-Framework. These were: (1) supportive organisational systems; (2) the physical environment; (3) appropriate skill mix.</p></div><div><h3>Results</h3><p>Several adaptations and changes were made addressing the three elements of “practice environment”. These were for example: (1) use of specific assessments, shared decision-making; (2) proper and effective use of aids; (3) integration of Advanced Practice Nurses. The adaptations in the patient pathway were integrated into the standard operating procedures.</p></div><div><h3>Conclusions</h3><p>Through active engagement with the practice development methodology and the focus on person-centredness, the process of care for elderly persons was adapted. Thus, by addressing individual needs, fast-track and person-centred care in geriatric traumatology is provided. Further research is needed to evaluate and to verify implications in clinical practice.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"51 ","pages":"Article 101065"},"PeriodicalIF":1.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134832591","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 : 2023-10-29DOI: 10.1016/j.ijotn.2023.101064
Pan She , Chun Huang , Lingli Peng , Jiaqi Yang , Ling Wang , Qingqing Liu , Hongying Tang
{"title":"The effects of osteoporosis education program for patients with fragility fracture in China","authors":"Pan She , Chun Huang , Lingli Peng , Jiaqi Yang , Ling Wang , Qingqing Liu , Hongying Tang","doi":"10.1016/j.ijotn.2023.101064","DOIUrl":"10.1016/j.ijotn.2023.101064","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"52 ","pages":"Article 101064"},"PeriodicalIF":1.4,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156929","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 : 2023-10-27DOI: 10.1016/j.ijotn.2023.101061
Lars Tobiesen Pedersen , Jonas Ammundsen Ipsen , Heidi Klakk Egebæk , Inge H. Bruun , Bjarke Viberg , Pernille Tanggaard Andersen
Background
It is essential to focus on how older adults remain active and regain control of their daily lives after hip fractures. ‘Rehabilitation of Life’ is an empowerment-orientated hip fracture intervention focused on continuous rehabilitation and care between sectors in Denmark. We aimed to understand and explore older adults' experience participating in the intervention ‘Rehabilitation of Life’ and how this relates to their sense of empowerment.
Method
Qualitative data were generated from 16 semi-structured interviews with patients experiencing a hip fracture and subsequent rehabilitation in the program “Rehabilitation of Life’ The data was analysed using Graneheim and Lundman's concept-guided qualitative content analysis method.
Results
The analysis revealed five themes that the participants emphasised as vital to their rehabilitation: getting information and care when hospitalised, early visits from healthcare professionals after returning to their homes, the social aspect of training together with others, rehabilitation provision by skilled and empathic staff, and acceptance of a new me. The five themes indicated that adults aged >65 years generally experienced rehabilitation after hip fractures as motivating and reassuring.
Conclusion
Social support and peer programs can significantly improve the rehabilitation of older adults with hip fractures. The Rehabilitation of Life intervention has shown that promoting successful rehabilitation requires patient-centred strategies that encourage collaboration between different sectors. To increase patients' empowerment and engagement in their health journey, it is important to consider changes in patients' behaviour, increase their autonomy and ensure their independence after rehabilitation.
{"title":"From fear to control: Older adults’ thoughts and feelings about empowerment-oriented rehabilitation after a hip fracture","authors":"Lars Tobiesen Pedersen , Jonas Ammundsen Ipsen , Heidi Klakk Egebæk , Inge H. Bruun , Bjarke Viberg , Pernille Tanggaard Andersen","doi":"10.1016/j.ijotn.2023.101061","DOIUrl":"10.1016/j.ijotn.2023.101061","url":null,"abstract":"<div><h3>Background</h3><p>It is essential to focus on how older adults remain active and regain control of their daily lives after hip fractures. ‘Rehabilitation of Life’ is an empowerment-orientated hip fracture intervention focused on continuous rehabilitation and care between sectors in Denmark. We aimed to understand and explore older adults' experience participating in the intervention ‘Rehabilitation of Life’ and how this relates to their sense of empowerment.</p></div><div><h3>Method</h3><p>Qualitative data were generated from 16 semi-structured interviews with patients experiencing a hip fracture and subsequent rehabilitation in the program “Rehabilitation of Life’ The data was analysed using Graneheim and Lundman's concept-guided qualitative content analysis method.</p></div><div><h3>Results</h3><p>The analysis revealed five themes that the participants emphasised as vital to their rehabilitation: <em>getting information and care when hospitalised, early visits from healthcare professionals after returning to their homes, the social aspect of training together with others, rehabilitation provision by skilled and empathic staff, and acceptance of a new me.</em> The five themes indicated that adults aged >65 years generally experienced rehabilitation after hip fractures as motivating and reassuring.</p></div><div><h3>Conclusion</h3><p>Social support and peer programs can significantly improve the rehabilitation of older adults with hip fractures. The Rehabilitation of Life intervention has shown that promoting successful rehabilitation requires patient-centred strategies that encourage collaboration between different sectors. To increase patients' empowerment and engagement in their health journey, it is important to consider changes in patients' behaviour, increase their autonomy and ensure their independence after rehabilitation.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"53 ","pages":"Article 101061"},"PeriodicalIF":1.4,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878124123000655/pdfft?md5=d0c783788fe03cd4304b148f5056f7cc&pid=1-s2.0-S1878124123000655-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.1016/j.ijotn.2023.101060
Xiaoqiong Peng , Ping Xiao , Yuanyuan Liu , Tianwen Huang , Xiaomin Huang , Wanlian Xiao , Sijia Deng
Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors.
Objective
To gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms.
Methods
Based on the “6 S” pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence.
Results
Thirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted.
Conclusion
The study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients.
骨质疏松性骨折是骨质疏松症的严重并发症,通常采用手术治疗,其恢复与个人的行为和生活方式密切相关,是一个长期、复杂的管理过程,往往需要个体对许多与健康相关的因素进行自我管理。收集和综合有关骨质疏松性骨折术后患者自我管理的最有力证据,为临床医护人员提供科学、循证的指导,协助术后患者进行自我管理,并帮助患者优化自我管理实践和行为规范。基于证据资源的“6s”金字塔模型(系统、摘要、综合大纲、综合、研究大纲、研究),我们检索了Up To Date、BMJ最佳实践、Cochrane图书馆、澳大利亚乔安娜布里格斯研究所JBI循证医学中心卫生保健数据库、国家卫生与临床卓越研究所(NICE)、指南国际网络(GIN)、国家指南交换所(NGC)和苏格兰校际指南网络(SIGN)。检索MedPulse、Embase、PubMed、CINAHL、Web of Science、SinoMed、中华医学期刊全文数据库、CNKI、万方数据知识服务平台、VIP数据库等,检索期为骨质疏松性骨折术后患者自我管理的临床决策、系统评价、临床指南、证据总结和专家共识,检索期为数据库建立至2023年2月18日。为保证文献质量,由3名研究者按照文献纳入和排除标准对文献进行严格筛选,2名或2名以上研究者独立评价纳入文献的质量,并对相关证据进行提取和整合。最终纳入文献13篇,其中临床实践指南4篇,专家共识5篇,推荐做法2篇,系统评价1篇,临床决策报告1篇。研究团队从多学科团队合作、日常生活管理、治疗依从性管理、运动管理、预防跌倒及后续骨折管理、情绪管理6个维度对证据进行总结,提取证据33条。本研究总结了33例骨质疏松性骨折术后患者自我管理的最佳证据,为术后患者提供科学合理的自我管理方案,也为临床医护人员对患者进行更全面、科学的自我管理健康教育提供重要参考和信息。
{"title":"Summary of best evidence for self-management in postoperative osteoporotic fracture patients","authors":"Xiaoqiong Peng , Ping Xiao , Yuanyuan Liu , Tianwen Huang , Xiaomin Huang , Wanlian Xiao , Sijia Deng","doi":"10.1016/j.ijotn.2023.101060","DOIUrl":"10.1016/j.ijotn.2023.101060","url":null,"abstract":"<div><p>Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors.</p></div><div><h3>Objective</h3><p>To gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms.</p></div><div><h3>Methods</h3><p>Based on the “6 S” pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence.</p></div><div><h3>Results</h3><p>Thirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted.</p></div><div><h3>Conclusion</h3><p>The study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"52 ","pages":"Article 101060"},"PeriodicalIF":1.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878124123000643/pdfft?md5=f3132f25bbb2c4d27e1d79e7b19624df&pid=1-s2.0-S1878124123000643-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136092906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-22DOI: 10.1016/j.ijotn.2023.101059
Massimo Guasconi , Dania Zilli Riboni , Andrea Civardi , Marina Bolzoni , Carlotta Granata , Maurizio Beretta , Anna Genovese , Fabio Mozzarelli , Fabrizio Quattrini , Pietro Maniscalco
Background
The adhesive elastic tape use is indicated for controlling oedema, although currently there is not the definitive evidence regarding its effectiveness. Wrist fractures are a frequent occurrence, often leading to oedema development in patients treated with forearm casts.
This pilot study aims to investigate the effects of elastic tape in controlling hand oedema among patients with forearm casts for wrist fractures and the feasibility of a future randomized controlled trial.
Methods
The study was conducted on adult patients with unilateral conservatively treated wrist fracture. The tape was applied to the intervention group after cast application, while the control group received the standard treatment. The circumference difference between baseline and the 7-day follow-up of both the 1st finger and the remaining 4 fingers merged together was evaluated. Ethical approval for the study has been obtained.
Results
23 participants were enrolled. The intervention group showed a higher reduction in finger circumferences compared to the control group (median difference T1-T0 No tape vs Tape: 0 cm vs −0.2 cm for the 1st finger and 0.5 cm vs −0.5 cm for the remaining 4 fingers), although the changes were not statistically significant.
Conclusion
Although the number of enrolled patients was limited due to Covid-19 pandemic, the study results suggest a potential reduction in oedema after the use of adhesive elastic tape, justifying the needed of a future full-scale study. Given its low cost and ease of use, we believe that tape can be considered in clinical practice.
{"title":"The use of adhesive elastic tape for hand oedema control in patients with a wrist fracture treated in a cast: A pilot study","authors":"Massimo Guasconi , Dania Zilli Riboni , Andrea Civardi , Marina Bolzoni , Carlotta Granata , Maurizio Beretta , Anna Genovese , Fabio Mozzarelli , Fabrizio Quattrini , Pietro Maniscalco","doi":"10.1016/j.ijotn.2023.101059","DOIUrl":"10.1016/j.ijotn.2023.101059","url":null,"abstract":"<div><h3>Background</h3><p>The adhesive elastic tape use is indicated for controlling oedema, although currently there is not the definitive evidence regarding its effectiveness. Wrist fractures are a frequent occurrence, often leading to oedema development in patients treated with forearm casts.</p><p>This pilot study aims to investigate the effects of elastic tape in controlling hand oedema among patients with forearm casts for wrist fractures and the feasibility of a future randomized controlled trial.</p></div><div><h3>Methods</h3><p>The study was conducted on adult patients with unilateral conservatively treated wrist fracture. The tape was applied to the intervention group after cast application, while the control group received the standard treatment. The circumference difference between baseline and the 7-day follow-up of both the 1st finger and the remaining 4 fingers merged together was evaluated. Ethical approval for the study has been obtained.</p></div><div><h3>Results</h3><p>23 participants were enrolled. The intervention group showed a higher reduction in finger circumferences compared to the control group (median difference T1-T0 No tape <em>vs</em> Tape: 0 cm <em>vs</em> −0.2 cm for the 1st finger and 0.5 cm <em>vs</em> −0.5 cm for the remaining 4 fingers), although the changes were not statistically significant.</p></div><div><h3>Conclusion</h3><p>Although the number of enrolled patients was limited due to Covid-19 pandemic, the study results suggest a potential reduction in oedema after the use of adhesive elastic tape, justifying the needed of a future full-scale study. Given its low cost and ease of use, we believe that tape can be considered in clinical practice.</p></div><div><h3>Trial registration</h3><p><span>ClinicalTrials.gov</span><svg><path></path></svg> Identifier: NCT04683887.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"53 ","pages":"Article 101059"},"PeriodicalIF":1.4,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1878124123000631/pdfft?md5=080d1d9462327f386e377fdfc32c84af&pid=1-s2.0-S1878124123000631-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136009937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-21DOI: 10.1016/j.ijotn.2023.101062
Yang Hong , Jie Wang , Xiafen Zhang , Dan Zhao , Hanliang He , Mengting Sun
Background
There is significant interest in the use of web-based technologies for rehabilitation of patients after total knee arthroplasty (TKA). BPMpathway is a combination of a wireless BPMpro sensor and mobile app to provide a personalized post-operative support programme for TKA patients.
Objective
To investigate the impact of the BPMpathway exercise rehabilitation system on home rehabilitation for TKA patients.
Methods
This study had a quasi-experimental design and was conducted with 42 inpatients after TKA. Patients were divided into a control group (n = 21) and an intervention group (n = 21) according to sequence of hospitalization. After discharge, patients in the control group received routine follow-up outside the hospital, while the intervention group, underwent out-of-hospital transitional care utilizing the BPMpathway exercise rehabilitation system. Knee function scores (HSS), quality of life scores (SF-36), and functional exercise compliance scores were compared between the two groups at 1, 3, and 6 months after TKA.
Results
The between-group differences in knee function were statistically significant at 1, 3, and 6 months post-operation (t = 6.299, 10.021, 13.064, all P < 0.05). There were between-group significant differences observed in functional exercise compliance and quality of life at 1 and 3 months (t = 7.166, 2.435, both P < 0.05; t = 2.879, 3.117, both P < 0.05). However, there were no significant differences at 6 months in these two respects (t = 0.167, 0.901, both P > 0.05).
Conclusions
The BPMpathway exercise rehabilitation system seems to be potential effective in improving knee function, early compliance with functional exercise and quality of life in TKA patients.
{"title":"The effectiveness of home rehabilitation based on BPMpathway exercise rehabilitation system for patients after total knee arthroplasty in China","authors":"Yang Hong , Jie Wang , Xiafen Zhang , Dan Zhao , Hanliang He , Mengting Sun","doi":"10.1016/j.ijotn.2023.101062","DOIUrl":"10.1016/j.ijotn.2023.101062","url":null,"abstract":"<div><h3>Background</h3><p>There is significant interest in the use of web-based technologies for rehabilitation of patients after total knee arthroplasty (TKA). BPMpathway is a combination of a wireless BPMpro sensor and mobile app to provide a personalized post-operative support programme for TKA patients.</p></div><div><h3>Objective</h3><p>To investigate the impact of the BPMpathway exercise rehabilitation system on home rehabilitation for TKA patients.</p></div><div><h3>Methods</h3><p>This study had a quasi-experimental design and was conducted with 42 inpatients after TKA. Patients were divided into a control group (n = 21) and an intervention group (n = 21) according to sequence of hospitalization. After discharge, patients in the control group received routine follow-up outside the hospital, while the intervention group, underwent out-of-hospital transitional care utilizing the BPMpathway exercise rehabilitation system. Knee function scores (HSS), quality of life scores (SF-36), and functional exercise compliance scores were compared between the two groups at 1, 3, and 6 months after TKA.</p></div><div><h3>Results</h3><p>The between-group differences in knee function were statistically significant at 1, 3, and 6 months post-operation (t = 6.299, 10.021, 13.064, all P < 0.05). There were between-group significant differences observed in functional exercise compliance and quality of life at 1 and 3 months (t = 7.166, 2.435, both P < 0.05; t = 2.879, 3.117, both P < 0.05). However, there were no significant differences at 6 months in these two respects (t = 0.167, 0.901, both P > 0.05).</p></div><div><h3>Conclusions</h3><p>The BPMpathway exercise rehabilitation system seems to be potential effective in improving knee function, early compliance with functional exercise and quality of life in TKA patients.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"53 ","pages":"Article 101062"},"PeriodicalIF":1.4,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61565498","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}