International Journal of Orthopaedic and Trauma Nursing最新文献_第6页

Patient experiences after surgically treated periprosthetic knee fracture in the distal femur – an explorative qualitative study 手术治疗股骨远端膝关节假体周围骨折后的患者体验-一项探索性定性研究

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-20 DOI: 10.1016/j.ijotn.2025.101194

S.K. Risager , T.A. Pedersen , B. Viberg , A. Odgaard , M. Lindberg-Larsen , C. Abrahamsen

Background

Periprosthetic knee fractures (PPKF) following total knee arthroplasty (TKA) are rare, but represents a potentially devastating complication. A significant gap in understanding patient experiences related to the surgical treatment and recovery process remains.

Objective

The aim of the study was to explore patients' experiences 3–4 months after surgical treatment of a PPKF in the distal femur.

Method

This exploratory qualitative study employed semi-structured, open-ended interviews with patients who had undergone surgical treatment for PPKF in the distal femur. Patients were recruited during hospitalization or at follow-up visits, with all approached individuals consenting to participate. Interviews were conducted three to four months post-surgery and data were analyzed thematically.

Results

Nine patients were interviewed between spring 2023 and spring 2024. The analysis yielded three themes: 1) Patient expectations of the recovery process, 2) Patient concerns – and consequently a desire for follow-up and information, and 3) The impact of recovery on independence and social life. Each theme was further illuminated with subthemes.

Conclusion

This study highlights the major challenges of recovering from PPKFs in the distal femur, including physical pain, psychological stress, and social disruption. Unlike elective TKAs, the sudden nature of PPKFs leaves patients unprepared for the lengthy recovery process, which often leads to frustration and isolation. Dependence on family for daily tasks can intensify the feeling of being a burden. To enhance patients’ recovery experiences and outcomes, clear communication and realistic expectations are essential in addressing these issues.

背景：全膝关节置换术（TKA）后假体周围膝关节骨折（PPKF）是罕见的，但代表了潜在的破坏性并发症。在了解与手术治疗和恢复过程相关的患者经验方面仍存在重大差距。目的探讨股骨远端PPKF手术治疗后3-4个月的患者体验。方法本探索性定性研究采用半结构化、开放式访谈的方法，对股骨远端PPKF手术治疗的患者进行访谈。在住院期间或随访期间招募患者，所有接触的个体都同意参与。术后三到四个月进行访谈，并对数据进行主题分析。结果在2023年春季至2024年春季期间对9例患者进行了访谈。该分析产生了三个主题：1)患者对康复过程的期望，2)患者的关注，以及因此对随访和信息的渴望，以及3)康复对独立性和社会生活的影响。每一个主题都以次级主题进一步阐明。结论：本研究强调了从股骨远端PPKFs中恢复的主要挑战，包括身体疼痛、心理压力和社会破坏。与选择性tka不同，PPKFs的突发性使患者对漫长的恢复过程毫无准备，这往往导致沮丧和孤立。在日常工作中对家人的依赖会加剧成为一种负担的感觉。为了提高患者的康复经验和结果，在解决这些问题时，明确的沟通和现实的期望是必不可少的。

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引用次数: 0

To lose weight or to weight the loss? Insights into the use of the body mass index in preoperative assessment before major orthopaedic surgery 是减肥还是加重体重？大骨科手术前体重指数在术前评估中的应用

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-17 DOI: 10.1016/j.ijotn.2025.101192

Matteo Briguglio , Marialetizia Latella , Claudio Cordani , Stefano Petrillo , Francesco Langella , Riccardo Cecchinato , Pedro Berjano , Fabrizio E. Pregliasco , Robert G. Middleton , Thomas W. Wainwright

The ERAS (Enhanced Recovery After Surgery) guidelines in major orthopaedic surgery do not address the issue of managing excess body weight in patients scheduled for hip and knee replacement or lumbar fusion. This aspect is relevant to practice due to the increasing number of obese individuals and to some evidence suggesting higher complication rates in patients with excess weight. There is a debate on whether obesity defined by the body mass index, i.e. the ratio of weight to squared height, can guide surgical eligibility and whether losing excess weight preoperatively can actually lead to better outcomes. In this practice development article, we explore opposing perspectives on the value of a high BMI as an indicator of increased preoperative risk and discuss the potential consequences of losing weight prior to a major orthopaedic surgery. The aim is to promote a conscious management of individuals with excess body fat based on the patient's overall health rather than BMI alone. In the absence of strong evidence on what is best to do, it is reasonable to suggest that any prehabilitation initiatives should not focus on a rigid weight loss mandate but on a multidisciplinary, multimodal, and personalised approach that does not necessarily include a reduction in body weight.

骨科大手术的ERAS（术后增强恢复）指南并没有解决计划进行髋关节和膝关节置换术或腰椎融合术患者体重过重的问题。这方面与实践有关，因为肥胖个体数量不断增加，一些证据表明超重患者的并发症发生率更高。关于体重指数（即体重与身高的平方之比）定义的肥胖是否可以指导手术资格，以及术前减掉多余的体重是否真的能带来更好的结果，目前存在争议。在这篇实践发展文章中，我们探讨了关于高BMI作为术前风险增加指标的价值的对立观点，并讨论了大型骨科手术前减肥的潜在后果。其目的是促进对身体脂肪过多的个体进行有意识的管理，这是基于患者的整体健康状况，而不仅仅是BMI。在缺乏强有力的证据证明什么是最好的情况下，我们有理由建议，任何康复计划都不应侧重于严格的减肥任务，而应侧重于多学科、多模式和个性化的方法，而不一定包括减轻体重。

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引用次数: 0

Summary of best evidence for secondary fracture prevention in postmenopausal osteoporosis patients 绝经后骨质疏松患者预防继发性骨折的最佳证据综述

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-14 DOI: 10.1016/j.ijotn.2025.101190

Chenghui Li , Haiyan Gu , Tingting Wang , Qin Xuan , Hong Gao

Objective

To evaluate and summarize the available evidence for secondary fracture prevention of postmenopausal osteoporosis and provide reference for clinical practice.

Methods

UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Guideline Clearing-house, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, Yi Mai tong Guidelines Network, the Cochrane Library, PubMed, Web of Science, Embase, SinoMed, CNKI, VIP and Wan Fang database were searched from January 2015 to February 2025. Literature types included clinical decision-making, best practices, guidelines, expert consensus, systematic reviews, evidence summaries and original research.

Results

28 literature were included, including 9 guidelines, 6 expert consensus, 6 systematic reviews and 7 randomized controlled trials. The study summarized 20 pieces of evidence on exercise safety, environmental safety, nutrition safety, medication safety, and health education.

Conclusion

The 20 recommended pieces of evidence for secondary fracture prevention of postmenopausal osteoporosis offer an evidence-based guide for nurses. However, cultural factors should be considered before applying these internationally sourced recommendations.

目的评价和总结绝经后骨质疏松症预防继发性骨折的现有证据，为临床实践提供参考。方法检索2015年1月至2025年2月的suptodate、BMJ Best Practice、Joanna Briggs Institute、Guidelines International Network、National Guidelines clearinghouse、Scottish Intercollegiate Guidelines Network、National Institute for Health and Care Excellence、Yi Mai tong Guidelines Network、Cochrane Library、PubMed、Web of Science、Embase、SinoMed、CNKI、VIP和万方数据库。文献类型包括临床决策、最佳实践、指南、专家共识、系统评价、证据摘要和原始研究。结果共纳入文献28篇，其中指南9篇，专家共识6篇，系统评价6篇，随机对照试验7篇。该研究总结了关于运动安全、环境安全、营养安全、药物安全以及健康教育的20项证据。结论20条推荐证据为绝经后骨质疏松症预防继发性骨折提供循证指导。然而，在应用这些国际来源的建议之前，应考虑文化因素。

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引用次数: 0

The effect of preoperative education on fear of first mobilization experienced after total knee arthroplasty in individuals 术前教育对个体全膝关节置换术后第一次活动恐惧的影响

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-01 DOI: 10.1016/j.ijotn.2025.101189

Ayşegül Kaya İmrek , Meryem Yilmaz

Objective

Total knee arthroplasty is a surgical intervention performed to reduce pain and movement restriction resulting from advanced joint deformity in individuals diagnosed with osteoarthritis, and to improve their quality of life and functionality. Meeting the preoperative educational needs of individuals undergoing total knee arthroplasty positively impacts postoperative recovery, mobilization, and rehabilitation. In this context, this study was conducted to determine the effect of preoperative education on fear of mobilization experienced after surgery in individuals who have undergone total knee arthroplasty.

Materials and methods

This study, was conducted using a single-group pre-test-post-test model, included 36 individuals who underwent total knee arthroplasty. Data were collected preoperatively and postoperatively using a questionnaire, a fear of falling and fall history assessment form, a Visual Analog Scale-10 (VAS-10), and a fall information exchange form.

Results

The average age of the 36 participants (27 women [75 %]; 9 men [25 %]) was 65.56 ± 4.39 years. The pre-education level of fear was 5.09 ± 1.57, the post-education level of fear was 3.73 ± 0.68, and the level of fear of pre-mobilization was 4.08 ± 0.81. A statistically significant difference was found between the pre-education and post-education level of fear of mobilization (t = 8.324, p = 0.000), between the post-education level and the level of fear before the first mobilization (t = −22.293, p = 0.000). However, it should be noted that fear of mobilization slightly increased during the postoperative first mobilization compared to after education; this may be related to patients' fear of mobilization, pain or anxiety.

Conclusion

The results of this study show that preoperative education provided to individuals undergoing total knee arthroplasty has positive effects on reducing fear of first mobilization experienced after surgery.

目的全膝关节置换术是一种外科干预措施，用于减少诊断为骨关节炎的个体因关节晚期畸形引起的疼痛和活动限制，并改善其生活质量和功能。满足全膝关节置换术患者术前教育需求对患者术后恢复、活动和康复有积极影响。在此背景下，本研究旨在确定术前教育对全膝关节置换术患者术后活动恐惧的影响。材料和方法本研究采用单组前-后-测试模型，包括36例接受全膝关节置换术的患者。术前和术后使用问卷、跌倒恐惧和跌倒史评估表、视觉模拟量表-10 （VAS-10）和跌倒信息交换表收集数据。结果36例参与者平均年龄（女性27例，占75%）；男性9例（25%），65.56±4.39岁。教育前恐惧水平为5.09±1.57，教育后恐惧水平为3.73±0.68，动员前恐惧水平为4.08±0.81。教育前与教育后动员恐惧水平差异有统计学意义（t = 8.324, p = 0.000），教育后与第一次动员前的恐惧水平差异有统计学意义（t = - 22.293, p = 0.000）。然而，需要注意的是，与教育后相比，术后第一次活动时对活动的恐惧略有增加；这可能与患者害怕活动、疼痛或焦虑有关。结论对全膝关节置换术患者进行术前教育对减少术后首次活动的恐惧有积极作用。

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引用次数: 0

Enhanced recovery pathways improve early outcomes and reduce length of stay in primary hip and knee arthroplasty: A systematic review of randomized controlled trials 增强的恢复途径改善了初级髋关节和膝关节置换术的早期结果并缩短了住院时间：一项随机对照试验的系统综述

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-01 DOI: 10.1016/j.ijotn.2025.101186

Larissa Sattler , Elizabeth Puze , Kendal Sands , William Talbot

Background

Enhanced Recovery After Surgery (ERAS) protocols represent an evidence-based approach to perioperative care, though evidence from randomized controlled trials in primary hip and knee arthroplasty remains limited.

Objective

This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) comparing ERAS protocols with standard care for primary hip and knee arthroplasty.

Methods

Four databases were searched following PRISMA guidelines. RCTs comparing ERAS protocols with standard care for primary hip or knee arthroplasty were included. Primary outcome was length of stay (LOS), with secondary outcomes including patient-reported outcomes, functional measures, and complications.

Results

Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced LOS by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favoured ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. The role of multidisciplinary teams, particularly nurse coordinators, was identified as an important for protocol success.

Conclusion

This systematic review of RCTs provides strong evidence that ERAS pathways reduce length of stay following primary hip and knee arthroplasty without compromising patient outcomes or safety. While ERAS protocols were associated with improved early functional recovery, heterogeneity in assessment methods limits definitive conclusions.

尽管来自原发性髋关节和膝关节置换术的随机对照试验的证据仍然有限，但手术后增强恢复（ERAS）方案代表了一种循证的围手术期护理方法。目的本系统综述旨在综合随机对照试验（rct）的证据，比较ERAS方案与标准护理在原发性髋关节和膝关节置换术中的应用。方法按照PRISMA指南对4个数据库进行检索。纳入了比较ERAS方案与标准护理的初级髋关节或膝关节置换术的rct。主要结局是住院时间（LOS），次要结局包括患者报告的结局、功能测量和并发症。结果5项rct（710例）符合纳入标准。与标准治疗相比，ERAS途径平均减少了4.7天的LOS。ERAS方案的患者表现出良好的早期功能恢复，特别是在术后第一周，在活动能力测试和日常活动方面的表现有所改善。患者报告的结果通常支持ERAS方案，尽管测量异质性限制了综合。没有研究报告ERAS实施后并发症增加。多学科小组的作用，特别是护士协调员，被认为是协议成功的重要因素。结论：对随机对照试验的系统回顾提供了强有力的证据，表明ERAS通路在不影响患者预后或安全性的情况下缩短了初次髋关节和膝关节置换术后的住院时间。虽然ERAS方案与改善早期功能恢复有关，但评估方法的异质性限制了明确的结论。

{"title":"Enhanced recovery pathways improve early outcomes and reduce length of stay in primary hip and knee arthroplasty: A systematic review of randomized controlled trials","authors":"Larissa Sattler , Elizabeth Puze , Kendal Sands , William Talbot","doi":"10.1016/j.ijotn.2025.101186","DOIUrl":"10.1016/j.ijotn.2025.101186","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols represent an evidence-based approach to perioperative care, though evidence from randomized controlled trials in primary hip and knee arthroplasty remains limited.</div></div><div><h3>Objective</h3><div>This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) comparing ERAS protocols with standard care for primary hip and knee arthroplasty.</div></div><div><h3>Methods</h3><div>Four databases were searched following PRISMA guidelines. RCTs comparing ERAS protocols with standard care for primary hip or knee arthroplasty were included. Primary outcome was length of stay (LOS), with secondary outcomes including patient-reported outcomes, functional measures, and complications.</div></div><div><h3>Results</h3><div>Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced LOS by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favoured ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. The role of multidisciplinary teams, particularly nurse coordinators, was identified as an important for protocol success.</div></div><div><h3>Conclusion</h3><div>This systematic review of RCTs provides strong evidence that ERAS pathways reduce length of stay following primary hip and knee arthroplasty without compromising patient outcomes or safety. While ERAS protocols were associated with improved early functional recovery, heterogeneity in assessment methods limits definitive conclusions.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"57 ","pages":"Article 101186"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discharge transition experience and nursing needs of elderly patients with hip fracture: A qualitative systematic review [Letter] 老年髋部骨折患者出院过渡经验与护理需求的定性系统评价[j]。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-01 DOI: 10.1016/j.ijotn.2025.101177

Sari Luthfiyah , Triwiyanto Triwiyanto , Hery Sumasto , Mohammed Ismath

This letter addresses the article "Discharge Transition Experience and Nursing Needs of Elderly Patients with Hip Fracture: A Qualitative Systematic Review" by Chun Huang et al., published in the International Journal of Orthopaedic and Trauma Nursing. The review offers valuable insights into the discharge transition experiences and nursing needs of elderly patients recovering from hip fractures, emphasizing critical aspects of care, such as rehabilitation, emotional well-being, and coordinated discharge planning. However, the review has notable limitations, including its focus on studies from developed countries, exclusion of patients with significant cognitive impairments, and the absence of quantitative data on the effectiveness of nursing interventions. Future research should aim to include a broader range of patient populations, particularly those with cognitive impairments, and consider diverse healthcare systems. Incorporating mixed-methods research and digital health technologies could also enhance the understanding and management of discharge transitions. The letter concludes by appreciating the contributions of the original review and suggesting directions for further research to improve care for elderly hip fracture patients.

此信针对黄春等发表在《国际骨科与创伤护理杂志》上的文章《老年髋部骨折患者出院过渡经验与护理需求：定性系统综述》。该综述为老年髋部骨折患者的出院过渡经验和护理需求提供了有价值的见解，强调了护理的关键方面，如康复、情绪健康和协调出院计划。然而，该综述有明显的局限性，包括其关注于来自发达国家的研究，排除了有明显认知障碍的患者，以及缺乏关于护理干预有效性的定量数据。未来的研究应着眼于包括更广泛的患者群体，特别是那些有认知障碍的患者，并考虑不同的医疗保健系统。结合混合方法研究和数字卫生技术还可以加强对出院过渡的理解和管理。这封信最后感谢了原始综述的贡献，并建议了进一步研究的方向，以改善老年髋部骨折患者的护理。

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引用次数: 0

Feasibility of repeated early mobilization in orthostatic intolerance after total hip arthroplasty 全髋关节置换术后直立不耐受患者早期重复活动的可行性

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-01 DOI: 10.1016/j.ijotn.2025.101187

Mikkel Nicklas Frandsen , Jesper Mehlsen , Claus Varnum , Martin Lindberg-Larsen , Nicolai Bang Foss , Henrik Kehlet

Introduction

Orthostatic intolerance (OI) is a barrier for early mobilization and same-day discharge after total hip arthroplasty (THA), with an estimated 30 % of patients affected within the first 6 h after surgery. Since repeated mobilization is known to be valuable in non-surgical OI conditions, we aimed to evaluate the feasibility of an early standardized repeated mobilization procedure as treatment of postoperative OI after THA.

Methods

This study was a single-arm, two-center hypothesis-generating feasibility study in patients undergoing THA. At first mobilization 4 h after surgery patients were categorized as having orthostatic tolerance (OT) or OI. Patients with OI underwent an hourly standardized repeated mobilization procedure until achieving OT or reaching 8 h post-surgery.

Results

Of 84 patients screened for OI, 25 (30 %) had OI 4 h postoperatively. Four patients left the study before achieving OT. Of the 21 completing the study per protocol, 16 patients achieved OT at 5 h and the remaining 5 achieved OT at 6 h postoperatively.

Discussion

Early repeated mobilization in patients with postoperative OI was feasible and potentially valuable after THA. This hypothesis-generating study calls for future large-scale studies in surgical patients with OI.

直立不耐受（OI）是全髋关节置换术（THA）后早期活动和当日出院的障碍，估计有30%的患者在手术后最初6小时内受到影响。由于反复活动在非手术性成骨不全中是有价值的，我们的目的是评估早期标准化反复活动手术治疗THA术后成骨不全的可行性。方法本研究是一项单臂、双中心的可行性研究，研究对象为THA患者。术后第一次活动4小时，患者被分类为直立耐受（OT）或成骨不全。成骨不全患者每小时进行一次标准化的重复活动，直到完成OT或术后8小时。结果84例成骨不全患者中，25例（30%）术后4小时成骨不全。4名患者在完成OT前退出了研究。在每个方案完成研究的21名患者中，16名患者在术后5小时达到OT，其余5名患者在术后6小时达到OT。讨论THA术后成骨不全患者早期反复活动是可行的，并且具有潜在的价值。这项产生假设的研究呼吁未来对手术成骨不全患者进行大规模研究。

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引用次数: 0

Corrigendum to “Feasibility of repeated early mobilization in orthostatic intolerance after total hip arthroplasty” [International J. Orthopaedic Trauma Nurs. 57 (2025) 101187] “全髋关节置换术后直立不耐受患者早期重复活动的可行性”[j].国际骨科创伤护理杂志，57(2025)101187]。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-01 DOI: 10.1016/j.ijotn.2025.101188

Mikkel Nicklas Frandsen , Jesper Mehlsen , Claus Varnum , Martin Lindberg-Larsen , Nicolai Bang Foss , Henrik Kehlet

引用次数: 0

Ijotn 101184:Response letter to comment letter of YJOON-D-24-00130 ijon 101184：对yjon - d -24-00130评议函的回复函。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-05-01 DOI: 10.1016/j.ijotn.2025.101184

Lingli Peng , Chun Huang

引用次数: 0

Postoperative recovery in orthopedic surgery: Exploring the roles of pain intensity, opioid consumption, pain catastrophizing, and emotional distress 骨科术后恢复：探讨疼痛强度、阿片类药物消耗、疼痛灾难化和情绪困扰的作用

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2025-04-23 DOI: 10.1016/j.ijotn.2025.101185

Heba Khalil , Abedalmajeed Shajrawi , Fatma Refaat Ahmed , Wegdan Bani-Issa , Nabeel Al-Yateem , Loai Abu Shahrour , Alham Al-Sharman , Muhammad Arsyad Subu , Richard Mottershead , Ahmed Mohammad Al-Smadi , Khalil Yousef

Background

Quality of Recovery (QoR) is a multidimensional construct that includes physical, psychological, and functional domains and is a key indicator of surgical outcomes. Better QoR is linked to shorter hospital stays, fewer complications, and greater patient satisfaction.

Purpose

This study evaluates the QoR of postoperative orthopedic patients in Jordan, focusing on the impact of pain, pain management, and emotional distress on recovery.

Methods

A cross-sectional study was conducted with 300 postoperative orthopedic patients within 24 h of surgery. Data included demographic and clinical information, preoperative and postoperative pain, and patient-reported outcomes using the Depression Anxiety and Stress Scale (DASS), Pain Catastrophizing Scale (PCS), and the Quality of Recovery-40 (QoR-40) questionnaire. Statistical analyses included t-tests, ANOVA, correlation, and linear regression.

Results

The mean QoR-40 score was 156.48 ± 19.65, with 61 % reporting a "good recovery", 36.7 % an "excellent recovery", and 2.6 % a "poor recovery". Higher preoperative and postoperative pain correlated with lower QoR scores (r = −0.26 and −0.46, p < 0.001). Greater opioid consumption in the first 24 h post-surgery correlated with better recovery (B = 0.28, p = 0.00). Emotional distress, particularly pain catastrophizing (B = −0.22, p = 0.01) and stress (B = −0.48, p = 0.00), was associated with a negative impact on QoR. Additionally, nonsmokers, married individuals, unemployed patients, and those undergoing arthroscopy reported better recovery (p < 0.001).

Conclusion

Findings highlight the importance of integrated physical and emotional management strategies to optimize QoR, reduce complications, and enhance patient satisfaction.

康复质量（QoR）是一个多维结构，包括身体、心理和功能领域，是手术结果的关键指标。更好的QoR与更短的住院时间、更少的并发症和更高的患者满意度有关。目的本研究评估约旦骨科术后患者的QoR，重点关注疼痛、疼痛管理和情绪困扰对康复的影响。方法对300例骨科术后24 h内患者进行横断面研究。数据包括人口统计学和临床信息、术前和术后疼痛、患者报告的抑郁、焦虑和压力量表（DASS）、疼痛灾难量表（PCS）和恢复质量40 （QoR-40）问卷。统计分析包括t检验、方差分析、相关分析和线性回归。结果QoR-40平均评分为156.48±19.65，其中“良好”为61%，“极好”为36.7%，“较差”为2.6%。术前和术后较高的疼痛与较低的QoR评分相关(r = - 0.26和- 0.46,p <；0.001)。术后24 h阿片类药物用量越大，恢复越好（B = 0.28, p = 0.00）。情绪困扰，特别是疼痛灾难化（B = - 0.22, p = 0.01）和压力（B = - 0.48, p = 0.00）与QoR的负面影响相关。此外，不吸烟者、已婚人士、失业患者和接受关节镜检查的患者报告恢复较好(p <；0.001)。结论综合身心管理策略对优化QoR、减少并发症、提高患者满意度具有重要意义。

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引用次数: 0