Main Article Content
The aim of this prospective study was to compare pain, physical activity, and quality of life among older adults undergoing hip and knee surgery between pre- and post-surgery. The ninety-five older adults (aged sixty years old and over) with hip fracture or hip-knee conditions scheduled for surgery and admitted at the general orthopaedic, private orthopaedic, intermediate orthopaedic, traumatic, and Somdej Pra Thep wards, a tertiary care hospital in Bangkok, were invited to participate in this study. The older adults who met inclusion criteria were recruited in this study. The participants were asked to sign an informed consent before they were interviewed by using the Numeric Rating Scale, the Modified Barthel Activities of Daily Index, and the Osteoarthritis of Knee Hip Quality of Life Questionnaire. Data were collected at the admission before surgery, before discharge to home, and the 6-week postoperative follow-up at the outpatient orthopaedic department. Descriptive statistic and inferential statistical analysis (paired t-test) were performed to analyze the data. A p-value of .05 was set for a statistically significant level.
The results of this study show that there is a statically significant improvement of pain 6 weeks after surgery compared to before discharge (p-value = 0.03). This improvement was also observed in the quality of life 6 weeks after surgery compared to before surgery (p-value = 0.02). For the physical activity, the difference between 6 weeks before and after surgery was not statistically significant (p-value = 0.86)
This study concluded that the findings from this study are beneficial for the healthcare team to understand the changes in pain and quality of life among older adults undergoing knee and hip surgery, and shed light on how to initiate any interventions to promote postoperative physical activity among this population. A long term monitoring change, more than 6-week follow-up, in pain, physical activity, and quality of life is also recommended.
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
2. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69.
3. Moore TJ, Gottschalk MB. Hip fracture. In: Lubin MF, Dodson TF, Winawer HN, editors. Medical management of the surgical patient. New York: Cambridge University Press; 2013. p.724-26.
4. Maradit KH, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner C, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015;97(17):1386-97.
5. Rynder SD, Hart JA. Orthopaedics for physician assistants. 1st ed. Philadelphia, PA: Elseiver/Saunders; 2013.
6. Sveinsdottir H, Skuladottir H. Postoperative psychological distress in patients having total hip or knee replacement: an exploratory panel study. Orthop Nurs. 2012;31 (5):302-11.
7. Bade MJ, Kohrt WM, Stevens-Lapsley JE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther. 2010;40(9):559-67.
8. Khamwong W, Nusawad J, Pratanworapanya W, Siripanya J. Factors relating to quality of life of elderly. Journal of Health Science Research. 2010;5(2):32-40. (in Thai)
9. World Health Organization. International classification of functioning, disability, and health; 2001 [cited 2016 Jun 16]. Available from World Health Organization Website: https://www.who.int/classifications/icf/en/
10. Purakom A, Tanomsuk M, Pupanead S, Chanyaem C, Setthasirichot P. Physical activity guidelines for older adults. Nakhorn Prathom: Kasetsart University, Kamphaeng Saen Campus; 2013. (in Thai)
11. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Beh Res Methods. 2009;41:1149-60.
12. Trongsakul S, Lambert R, Clark A, Wongpakaran N, Cross J. Development of the Thai version of Mini-cog, a brief cognitive screening test. Geriatr Gerontol Int. 2015;15 (5):594-600.
13. Borson S, Scanlan JM, Chen P, Ganguli M. The mini-cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003;51(10):1451-4.
14. Pasero C, McCaffery M, Gordon DB. Build institutional commitment to improving pain management. Nurs Manage. 1999;30(1):27-34.
15. Mawdstly RH, Moran KA, Conniff LA. Reliability of two commanly used pain scales with elderly patients. J of Geriatr Phys Ther. 2002;25(3):16-20.
16. Jitapunkul S, Kamolratanakul P, Ebrahim S. The meaning of activities of daily living in a Thai elderly population: development of a new index. Age Ageing. 1994;23 (2):97-101.
17. Tamsat A, Aree-Ue S, Leelacharas S. Fear of falling and functional ability in older adults undergoing hip surgery. Journal of tje police Nurses. 2015;7(1):64-82.
18. Rat AC, Pouchot J, Coste J, Baumann C, Spitz E, Retel-Rude N, Guillemin F. Development and testing of a specific quality-of-life questionnaire for knee and hip osteoarthritis: OAKHQOL (OsteoArthritis of Hip Knee Quality Of Life). Joint Bone Spine. 2006;73(6):697-704.
19. Kane RL, Ouslander JG, Abrass IB, Resnick B. Essentials of clinical geriatrics. 6th ed. New York: McGraw-Hill; 2009.
20. Visitsakul S. Nursing care of the patient with osteoarthritis knee by supportive treatment. Journal of Thai Orthopaedic Nurses’ Society. 2012;17(1):4-13. (in Thai)
21. U.S. National Library of Medicine. Aging change in the bones–muscles–joint; 2016 [cited 2016 May 9]. Available from United States National Library of Medicine Website: https://www.nlm.nih.gov/medlineplus/ency/article/004015.htm.
22. Kwoh CK, Hwang YG. Osteoarthritis. In: Williams BA, Chang A, editors. Current diagnosis and treatment. Singapore: McGraw-Hill Education; 2014. p.159-68.
23. Haq SA, Davatchi F. Osteoarthritis of the knees in the COPCORD world. Int J Rheum Dis. 2011;14(2):122-9.
24. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheum. 2008;58(1):26-35.
25. Metzger PC, Lombardi M. Orthopedic trauma. In: Kuaffman TL, Scott R, Barr JO, Moran ML, Wolf SL, editors. A comprehensive guide to geriatric rehabilitation. China: Elsevier; 2014. p.171-7.
26. Esktam AK, Elmstahi S. Do fall-risk-increasing drugs have an impact on mortality in older hip fracture patients? A population-based cohort study. Clin Interv Aging. 2016;11:489-96.
27. Thai Association for the Study of Pain. Clinical guideline for acute pain management. Bangkok; 2009. (in Thai)
28. Thienthong S. Acute pain management. Khonkaen: Khonkaen University Press; 2005. (in Thai)
29. Papakostidou I, Dailiana ZH, Papapolychroniou T, Liaropoulos L, Zintzaras E, Karachalios TS, et al. Factors affection the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet Disord. 2012;13(1):1-9.
30. Dailiana ZH, Papakostidou I, Varitimidis S, Liaropoulos L, Zintzaras E, Karachalios T, et al. Patient-reported quality of life after primary major joint arthroplasty: a prospective comparison of hip and knee arthroplasty. BMC Musculoskelet Disord. 2015;16(1):1-8.
31. Puolakka PA, Rorarius MG, Roviola M, Poulakka TJ, Nordhausen K, Lindgren L. Persistent pain following knee arthroplasty. Eur J Anaesthesiol. 2010;27(5):455-460.
32. Veal FC, Bereznicki LR, Thompson AJ, Perterson GM, Orlikowski C. Sub-acute pain as a predictor of long-term pain following orthopedic surgery: an Australian prospective 12 month observation cohort study. Medicine. 2015;94(36):1-6.
33. Ganz SB, Peterson MG, Russo PW, Guccione A. Functional recovery after hip fracture in the sub-acute setting. HSS J. 2007;3(1):50-57.
34. Givens JL, Sanft TB, Marcantonio ER. Functional recovery after hip fracture: the combined effect of depressive symptoms, cognitive impairment, and delirium. J Am Geriatr Soc. 2008;56(6):1075-9.
35. Meeprasert T. Quality of life at preoperative and postoperative period of hip surgery in older patients with hip fracture [thesis]. Nakhon Pathom: Mahidol University; 2007.
36. Nüesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Jüni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ. 2011;342:1-8.