Main Article Content

พิชญ์ประอร ยังเจริญ สุภาพ อารีเอื้อ นันทิกานต์ แสงทอน


                Total knee arthroplasty is one of the most common treatment for elderly patients with severe knee osteoarthritis. During post-operation, it is important to assess patients’ quality of life. The aim of this study was to examine the pain intensity level, physical activities, depression in predicting elderly patients undergoing total knee arthroplasty at 6-week quality of life. The samples in this study were one hundred elderly patients undergoing total knee arthroplasty at one tertiary care hospital in Bangkok, Thailand. The questionnaires included a demographic questionnaire, numeric rating scale, modified Barthel activities of daily index, Thai geriatric depression scale-15, and the osteoarthritis of knee hip quality of life questionnaire. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation coefficients, and multiple linear regression.

                The results indicated that pain intensity level had a strong negative correlation with quality of life (r = -.62, p < .01) whereas physical activities had a moderate positive correlation with quality of life (r = .33, p < .01). All predictors could explain 46% of variance in patients’ quality of life. The results suggested that it is necessary to have an intervention program to assess and manage pain after discharge as well as promoting physical activities for this population. This will then lead to enhancement of patients’ quality of life. 


Article Details

Research (บทความวิจัย)


Aree-Ue, S., Belza, B., Saraboon Y., & Youngcharoen, P. (2017). Effects of a multicomponent strategy trial (MUST) program on health outcomes in overweight and diabetic older adults with knee osteoarthritis. Unpublished raw data.
Borson, S., Scanlan, J., Brush, M., Vitaliano, P., & Dokmak, A. (2000). The mini-cog: A cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15(11), 1021-1027.
Canovas, F., & Dagneaux, L. (2018). Quality of life after total knee arthroplasty. Orthopaedics, Traumatology, Surgery, and Research, 104(1S), S41-S46.
Dailiana, Z. H., Papakostidou, I., Varitimidis, S., Liaropoulos, L., Zintzaras, E., Karachalios, T., … Malizos, K. N. (2015). Patient-report quality of life after primary joint arthroplasty: A prospective comparison of hip and knee arthroplasty. BMC Musculoskeletal Disorders, 26(16), 366.
Edwards, R. R., Haythornthwaite, J. A., Smith, M. T., Klick, B., & Katz, J. N. (2009). Catastrophizing and depressive symptoms as prospective predictors of outcomes following total knee replacement. Pain Research and Management: The Journal of the Canadian Pain Society, 14(4), 307–311.
Fitzgerald, J. D., Orav, E. J., Lee, T. H., Marcantonio, E. R., Poss, R., Goldman, L., & Mangione, C. M. (2004). Patient quality of life during the 12 months following joint replacement surgery. Arthritis and Rheumatism, 51(1), 100-109.
Gawel, J., Fibiger, W., Starowicz, A., & Szwarczyk, W. (2010). Early assessment of knee function and quality of life in patients after total knee replacement. Ortopedia, Traumatologia, Rehabilitacja, 12(4), 329-337.
Grosu, I, Lavand'homme, P., & Thienpont, E. (2014). Pain
after knee arthroplasty: an unresolved issue. Knee Surgery, Sports Traumatology, Arthroscopy, 22(8), 1744-58.
Herrero-Sanchez, M. D., Garcia-Inigo Mdel, C., Nuno-Beato-Redondo, B. S., Fernandez-de-Las-Penas, C., & Alburquerque-Sendin, F. (2014). Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty. Ciencia and Saude Coletiva, 19(6), 1881-1888.
Hyun, C. W., Kim, B. R., Han, E. Y., & Kim, S. R. (2016).
Preoperative physical performance predictors of self-reported physical function and quality of life in patients scheduled for total knee arthroplasty. Journal of Physical Therapy Science, 28(11), 3220-3226.
Jitapunkul, S., Kamolratanakul, P., & Ebrahim, S. (1994). The meaning of activities of daily living in a Thai elderly population: Development of a new index. Age and Ageing, 23, 97-101.
Kennedy, D. M., Hanna, S. E., Stratford, P. W., Wessel, J., & Gollish, J. D. (2006). Preoperative function and gender predict pattern of functional recovery after hip and knee arthroplasty. The Journal of Arthroplasty, 21(4), 559-566.
Kim, K. W., Han, J. W., Cho, H. J., Chang, C. B., Park, J. H., Lee, J. J., ... Kim, T. K. (2011). Association between comorbid depression and osteoarthritis symptom severity in patients with knee osteoarthritis. The Journal of Bone and Joint Surgery, 93(6), 556-563.
Koedwan, C., Bunin, J., Teerasombut, C., & Kuptniratsaikul, V. (2016). The prevalence of knee OA in community-based elders. Thai Journal of Physical Therapy, 38(2), 59-70.
Kuptniratsaikul, V., Tosayanonda, O., Nilganuwong, S., & Thamalikitkul, V. (2002). The epidemiology of osteoarthritis of the knee in elderly patients living an urban area of Bangkok. Journal of the Medical Association of Thailand, 85(2), 154-161.
Mawdsley, R. H., Moran, K. A., & Conniff, L. A. (2002). Reliability of two commonly used pain scales with elderly patients. Journal of Geriatric Physical Therapy, 25(3), 16-20.
Marhoney, F. I., & Bathel, D. W. (1965). Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, 61-65.
McCaffery, M., & Pasero, C. (1999). Pain: Clinical manual. St Louis, MO: Mosby.
Murphy, L., & Helmick, C. G. (2012). The impact of osteoarthritis in the United States: A population-health perspective. The American Journal of Nursing, 112(3), S13-19
Nunez, M., Lozano, L., Nunez, E., Segur, J. M., Sastre, S., Macule, F., ... Suso, S. (2009). Total knee replacement and health-related quality of life: Factors influencing long-term outcomes. Arthritis and Rheumatism, 61(8), 1062-1069.
Nunez, M., Nunez, E., del Val, J. L., Ortega, R., Segur, J. M., Hernandez, M. V., ... Macule, F. (2007). Health-related quality of life in patients with osteoarthritis after total knee replacement: Factors influencing outcomes at 36 months of follow-up. Osteoarthritis and Cartilage, 15(9), 1001-1007.
Papakostidou, I., Dailiana, Z. H., Papapolychroniou, T., Liaropoulos, L., Zintzaras, E., Karachalios, T. S., & Malizos, K. N. (2012). Factors affecting the quality of life after total knee arthroplasties: A prospective study. BMC Musculoskeletal Disorders, 13, 116-2474-13-116.
Pérez-Prieto, D., Gil-González, S., Pelfort, X., Leal-Blanquet, J., Puig-Verdié, L., & Hinarejos, P. (2014). Influence of depression on total knee arthroplasty outcome. The Journal of Arthroplasty, 29(1), 44-47.
Puolakka, P. A., Rorarius, M. G., Roviola, M., Puolakka, T. J., Nordhausen, K., & Lindgren, L. (2010). Persistent pain following knee arthroplasty. European Journal of Anaesthesiology, 27(5), 455-460.
Rat, A. C., Coste, J., Pouchot, J., Baumann, M., Spitz, E., Retel-Rude, N., ... & Guillemin, F. (2005). OAKHQOL: A new instrument to measure quality of life in knee and hip osteoarthritis. Journal of Clinical Epidemiology, 58(1), 47-55.
Riddle, D. L., Wade, J. B., Jiranek, W. A., & Kong, X. (2010). Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clinical Orthopaedics and Related Research, 468(3),
Singh, J. A., & Lewallen, D. G. (2014). Patient-level improvements in pain and activities of daily living after total knee arthroplasty. Rheumatology (Oxford, England), 53(2), 313-320.
Sullivan, M., Tanzer, M., Stanish, W., Fallaha, M., Keefe, F. J., Simmonds, M., & Dunbar, M. (2009). Psychological determinants of problematic outcomes following total knee arthroplasty. Pain, 143(1), 123-129.
Tamsat, A., Aree-Ue, S., & Leelacharas, S. (2015). Fear of falling and functional ability in older adults undergoing hip surgery, Journal of the Police Nurses, 7(1), 64-82.
Thailand Ministry of Public Health. (2013). The survey of elderly health. Retrieved from https://www.hitap.net/documents/24067
Trongsakul, S., Lambert, R., Clark, A., Wongpakaran, N., & Cross, J. (2015). Development of the Thai version of mini-cog, a brief cognitive screening test. Geriatrics and Gerontology International, 15(5), 594-600.
Vissers, M. M., Bussmann, J. B., Verhaar, J. A., Busschbach, J. J., Bierma-Zeinstra, S. M., & Reijman, M. (2012). Psychological factors affecting the outcome of total hip and knee arthroplasty: A systematic review. Seminars in Arthritis and Rheumatism, 41(4), 576-588
Wongpakaran, N. & Wongpakaran, T. (2012). Prevalence of major depressive disorders in long-term care facilities: A report from northern Thailand. Psychogeriatrics, 12(1), 11-17.
World Health Organization. (2001). International classification of functioning, disability, and health. Retrieved from https://www.who.int/classifications/icf/en/
Wu, C. L., Naqibuddin, M., Rowlingson, A. J., Lietman, S. A., Jermyn, R. M., & Fleisher, L. A. (2003). The effect of pain on health-related quality of life in the immediate postoperative period. Anesthesia and Analgesia, 97(4),