International Journal of Orthopaedic and Trauma Nursing最新文献

英文中文

The effectiveness of prophylactic closed incision negative pressure wound therapy compared to conventional dressings in the prevention of periprosthetic joint infection post hip and knee revision arthroplasty surgery: A systematic review 与传统敷料相比，预防性闭合切口负压伤口治疗在预防髋关节和膝关节翻修术后假体周围关节感染方面的有效性：一项系统综述。

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-09-01 DOI: 10.1016/j.ijotn.2023.101048

Tracy Morgan , Tamara Page

Objective

To evaluate the effectiveness of prophylactic closed incision negative pressure wound therapy (ciNPWT) compared to conventional dressings in the prevention of periprosthetic joint infection (PJI) post hip and knee revision arthroplasty surgery.

Method

Five databases (MEDLINE, Embase., Emcare, CINAHL and Scopus) were searched with no date or language limits. Two independent reviewers assessed articles against the inclusion criteria and methodological quality of the 3 included studies. Data was extracted using a customised data tool and included the intervention, study methods and outcomes of interest. A meta-analysis was performed, and results presented in narrative form with forest plots.

Findings

The three studies, one randomized control trial and two quasi-experimental studies, included 136 intervention and 228 control participants (Sample 364). The PJI rate decreased in the ciNPWT cohort compared to the conservative dressing cohort (2 [1.47%] vs 27 [11.84%]). The reoperation rate was lower in the ciNPWT cohort versus the conventional cohort (4 [2.94%] vs 35 [15.35%]). The rate of wound complications was significantly decreased in the ciNPWT cohort compared to the conventional dressing cohort (14 [10.29%] v 85 [37.28), p=<0.001).

Conclusion

Prophylactic application of ciNPWT may be effective in reducing wound complications, PJI and reoperation post hip and knee revision arthroplasty surgery. The added cost of ciNPWT may be justified in the reduction of wound complications, PJI and reoperation. Ongoing trials determining if the prophylactic application of ciNPWT post hip and knee revision arthroplasty surgery is beneficial in preventing PJI particularly in high risk patients with additional comorbidities are warranted.

目的：评价预防性闭合切口负压伤口治疗（ciNPWT）与传统敷料在预防髋关节和膝关节翻修术后假体周围关节感染（PJI）方面的有效性。方法：检索5个数据库（MEDLINE、Embase.、Emare、CINAHL和Scopus），没有日期或语言限制。两名独立评审员根据3项纳入研究的纳入标准和方法学质量对文章进行了评估。使用定制的数据工具提取数据，包括干预措施、研究方法和感兴趣的结果。进行了荟萃分析，结果以森林情节的叙述形式呈现。研究结果：这三项研究，一项随机对照试验和两项准实验研究，包括136名干预参与者和228名对照参与者（样本364）。与保守敷料队列相比，ciNPWT队列的PJI发生率降低（2[1.47%]vs 27[11.84%]）。与传统敷料队列相比（4[2.94%]vs 35[15.35%]），ciNPWT队列的再次手术率较低。与传统包扎队列相比（14[10.29%]vs 85[37.28），ciNPWT队列的伤口并发症发生率显著降低结论：预防性应用ciNPWT可有效减少髋关节和膝关节翻修术后的伤口并发症、PJI和再次手术。ciNPWT的增加成本可能在减少伤口并发症、PJI和再次手术方面是合理的。正在进行的试验确定在髋关节和膝关节翻修术后预防性应用ciNPWT是否有利于预防PJI，特别是在有其他合并症的高危患者中。

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引用次数: 0

Patients’ experiences of urinary retention and bladder care – A qualitative study in orthopaedic care 患者尿潴留与膀胱护理的经验——骨科护理的定性研究

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101034

Madeleine Winberg , Maria Hälleberg Nyman , Erika Fjordkvist , Eva Joelsson-Alm , Ann Catrine Eldh

Background

Urinary retention is a common complication associated with hip surgery. There are easily available, evidence-based clinical practice guidelines prescribing how to prevent both urinary retention and other voiding issues, by means of bladder monitoring and risk assessments. A detected lack of adherence to such guidelines increases risks for unnecessary suffering among patients but a greater understanding of patients’ experiences can benefit tailored interventions to address quality and safety gaps in orthopaedic nursing and rehabilitation.

Purpose

The aim was to describe patients’ experiences of urinary retention, bladder issues, and bladder care in orthopaedic care due to hip surgery.

Method

This was a qualitative study with a descriptive design: content analysis with an inductive approach was applied to interviews (n = 32) and survey free-text responses (n = 122) across 17 orthopaedic units in Sweden.

Results

The patients had received no or limited details for the recurrent bladder care interventions (such as bladder scans and prompted voiding) while at the hospital. They relied on the staff for safe procedures but were left to themselves to manage and comprehend prevailing bladder issues. Despite the patients’ experiences of bladder issues or the risk of urinary retention postoperatively, the link to hip surgery remained unknown to the patients, leaving them searching for self-management strategies and further care.

Conclusions

Patients’ perspectives on bladder care, urinary retention and bladder issues can serve as a means for increased understanding of procedures and issues, reinforcing improved implementation of guidelines, including person-centred information. Safer bladder procedures imply further patient engagement, highlighted in guidelines.

背景:尿潴留是髋关节手术的常见并发症。有很容易获得的、基于证据的临床实践指南，规定如何通过膀胱监测和风险评估来预防尿潴留和其他排尿问题。如果发现不遵守这些指导方针，会增加患者遭受不必要痛苦的风险，但更好地了解患者的经历有助于采取有针对性的干预措施，以解决骨科护理和康复方面的质量和安全差距。目的描述髋关节手术后患者尿潴留、膀胱问题和膀胱护理的经历。方法这是一项描述性设计的定性研究:采用归纳方法的内容分析应用于瑞典17个骨科单位的访谈(n = 32)和调查自由文本回复(n = 122)。结果患者在住院期间未接受或仅接受过多次膀胱护理干预(如膀胱扫描和提示排尿)。他们依靠工作人员的安全程序，但留给他们自己来管理和理解普遍的膀胱问题。尽管患者经历了膀胱问题或术后尿潴留的风险，但与髋关节手术的联系对患者来说仍然是未知的，这使得他们寻找自我管理策略和进一步的护理。结论患者对膀胱护理、尿潴留和膀胱问题的观点可以作为增加对程序和问题的理解的手段，加强指南的改进实施，包括以人为本的信息。指南中强调，更安全的膀胱手术意味着进一步的患者参与。

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引用次数: 0

Health and quality of life after discharge from hospital: A prospective study on opioid treatment for acute pain after trauma or surgery 出院后的健康和生活质量：阿片类药物治疗创伤或手术后急性疼痛的前瞻性研究。

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101017

Anne Mari Gunnheim Klausen , Jorunn Drageset , Frøydis Kristine Bruvik

Objectives

The aim of this study was to examine opioid use, health, quality of life, and pain after discharge from hospital in opioid naïve patients receiving opioid treatment for sub acute pain after trauma or surgery.

Methods

A prospective cohort with a four-week follow-up was conducted. Of the 62 patients included, 58 remained in the follow-up. The following questionnaires were assessed: Numeric Rating Scale for pain (NRS), EQ-5D-5L (health-related quality of life) and EQ-VAS (self-reported health). Paired t-test, two-sample t-test and chi square test were used in the study.

Results

Every fourth participant still received opioid treatment at follow-up, and reported no significant increase in EQ-VAS. Overall, an improvement in EQ-5D-5L (0.569 (SD = 0.233) to 0.694 (SD = 0.152), p < 0.001) and EQ-VAS (55 (SD = 20) to 63 (SD = 18), p = 0.001) from baseline to follow-up was found. Pain intensity decreased in the same period (6.4 (SD = 2.2) to 3.5 (SD = 2.6), p < 0.001). An unmet need for information regarding pain management was reported by 32% of the participants.

Conclusions

Our findings show that patients with acute pain, treated with opioids, reported improved pain intensity, health-related quality of life and self-reported health four weeks after discharge. There is room for improvement regarding the provision of patient information on pain management.

目的：本研究的目的是检查因创伤或手术后亚急性疼痛而接受阿片类药物治疗的阿片类天真患者的阿片药物使用、健康、生活质量和出院后疼痛。方法：进行为期四周的前瞻性队列随访。在包括在内的62名患者中，58名仍在随访中。评估了以下问卷：疼痛数字评定量表（NRS）、EQ-5D-5L（健康相关的生活质量）和EQ-VAS（自我报告的健康状况）。本研究采用配对t检验、双样本t检验和卡方检验。结果：在随访中，每四分之一的参与者仍然接受阿片类药物治疗，并且报告EQ-VAS没有显著增加。总体而言，EQ-5D-5L（0.569（SD=0.233）至0.694（SD=0.152）有所改善，p结论：我们的研究结果表明，接受阿片类药物治疗的急性疼痛患者在出院四周后报告疼痛强度、健康相关的生活质量和自我报告的健康状况有所改善。在提供患者疼痛管理信息方面还有改进的空间。

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引用次数: 0

Literature reviews 文学评论

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101033

Mary Drozd, Carmen Queiros, Shareena Bibi Mohd Arif

引用次数: 0

Editorial Board/Title Page 编委会/标题页

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/S1878-1241(23)00046-1

引用次数: 0

The effect of discharge training with the teach-back method on post-discharge challenges in lumbar disc herniation patients: A quasi-experimental study 背教法出院训练对腰椎间盘突出症患者出院后挑战的影响:一项准实验研究

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101020

Arzu Tat Çatal , Fatma Cebeci

Background

Shortened length of hospital stay in patients undergoing lumbar disc herniation surgery forces to undertake interventions that facilitate optimal patient outcomes.

Aim

The aim of this study was to investigate the effect of discharge training given by teach-back method, and counseling based on individual needs and a study-specific training booklet on postoperative pain and challenges experienced by lumbar disc herniation patients.

Methods

This study had a quasi-experimental design and was conducted with 94 patients. Patients were divided into a control group (n = 48) and an intervention group (n = 46) using the blocking method. The pain was assessed at the time of patient admission, at discharge, and at follow-up; postoperative challenges were evaluated at discharge and follow-up.

Results

Most patients experienced pain and challenges such as kinesiophobia, weakness-exhaustion-fatigue, irritability, constipation, and insomnia. The patients in the intervention group had less back and leg pain and challenges.

Conclusions

The benefits of education given by teach-back method, and counseling in reducing the postoperative problems experienced by patients who underwent surgery for lumbar disc herniation were demonstrated in this study. The findings suggest that study-specific training and counseling may be useful for addressing the pain and challenges of patients with lumbar disc herniation.

背景:腰椎间盘突出症手术患者住院时间的缩短迫使患者采取干预措施，以促进患者的最佳预后。目的本研究的目的是探讨采用背教方法进行出院训练、基于个体需求的咨询和研究特异性训练手册对腰椎间盘突出症患者术后疼痛和挑战的影响。方法采用准实验设计，共纳入94例患者。采用阻断法将患者分为对照组(n = 48)和干预组(n = 46)。疼痛在患者入院、出院和随访时进行评估;在出院和随访时评估术后挑战。结果大多数患者经历疼痛和挑战，如运动恐惧症、虚弱-疲惫-疲劳、易怒、便秘和失眠。干预组患者的背部和腿部疼痛和挑战较少。结论:本研究证实了以背教方式进行的教育和咨询在减少腰椎间盘突出症手术患者的术后问题方面的益处。研究结果表明，研究特定的训练和咨询可能有助于解决腰椎间盘突出症患者的疼痛和挑战。

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引用次数: 0

The effect of in-bed turning and mobilization training given to patients who undergo lumbar disk surgery on postoperative first mobility level: A single-blind, randomized controlled trial 对腰椎间盘手术患者进行卧床翻身和活动训练对术后首次活动水平的影响:一项单盲、随机对照试验

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101022

Hatice Akkaya , Hatice Ayhan

Objective

This study was conducted to investigate the effects of mobilization and in-bed turning training given through the role-playing technique to patients to undergo lumbar disk surgery on the patient's pain, strain and dependence level during the first postoperative mobilization (turning, sitting, standing and walking).

Methods

Patients who would undergo a lumbar disk hernia surgery were recruited from a neurosurgery clinic in Turkey. Patients who met inclusion criteria and agreed to participate (n = 40) in the study were randomly assigned to an intervention group (in-bed turning and mobilization training simulated with the role-playing technique, n = 19) and a control group (usual clinical care, n = 21). The outcome of the study was patient mobility and observer mobility scale scores.

Results

Postoperative scores obtained from the patient mobility and observer mobility scale were lower in the intervention group than the scores of the control group, and the difference between the groups was found statistically significant (p < 0.05). The anxiety levels of the intervention group before (38.00 ± 6.59, p < 0.001) and after mobilization (31.63 ± 4.57, p = 0.032) were significantly lower.

Conclusion

The findings indicate training improves patient care outcomes for first postoperative mobility. It is recommended that structured training for in-bed turning and mobilization should be integrated into routine clinical care in the preoperative period for patients to undergo lumbar disk hernia surgery.

Practice implications

Preoperative training increases the patient's willingness to be mobilized and decreases the anxiety level and perceived pain and strain.

目的探讨通过角色扮演技术对腰椎间盘手术患者进行活动和卧床翻身训练对患者术后第一次活动(翻身、坐、站、行)时疼痛、劳损及依赖程度的影响。方法从土耳其一家神经外科诊所招募将接受腰椎间盘突出手术的患者。符合纳入标准并同意参与研究的患者(n = 40)被随机分配到干预组(用角色扮演技术模拟床上翻身和活动训练，n = 19)和对照组(常规临床护理，n = 21)。研究的结果是患者活动能力和观察者活动能力量表得分。结果干预组术后患者活动能力评分、观察者活动能力评分均低于对照组，组间差异有统计学意义(p <0.05)。干预组治疗前焦虑水平(38.00±6.59,p <0.001)，活动后(31.63±4.57,p = 0.032)显著降低。结论培训可提高患者术后首次活动能力的护理效果。建议将床上翻身和活动的结构化训练纳入腰椎间盘突出症手术患者的术前常规临床护理。实践意义:术前训练提高了患者活动的意愿，降低了焦虑水平和感知的疼痛和紧张。

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Commentary 评论

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101032

Julie Santy-Tomlinson (Emeritus Editor in Chief and Social Media Editor)

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Focus on practice development: The value of sharing expertise 注重实践发展:分享专业知识的价值

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-08-01 DOI: 10.1016/j.ijotn.2023.101021

Wendy Duperouzel (Clinical Editor)

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Literature reviews 文献综述

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2023-05-01 DOI: 10.1016/j.ijotn.2023.101019

Mary Drozd, Carmen Queiros, Shareena Bibi Mohd Arif

引用次数: 0

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