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Pain Intensity and the Affecting Factors in Elderly Patients with Arthroplasty Surgery

Year 2018, Volume: 1 Issue: 3, 104 - 112, 31.12.2018

Abstract

Objective: The aim of this
study was to investigate the severity of pain and affecting factors experienced
by elderly patients with arthroplasty surgery.

 

Material and Methods: This is a cross-sectional descriptive
study. The data were collected from the Orthopedics and Traumatology Clinic of
a university hospital between February 2014-April 2015. Data were collected by
using top “Sociodemographic and Clinical Characteristics Form”, “Brief Pain
Inventory” and “Hospital Anxiety Depression Scale”. The study included 128
elderly patients who accepted to participate in the study. Ethics committee and
hospital permission were obtained.

 

Results: The mean age of the
elderly patients with arthroplasty surgery was 71,05±6,21 (min=65, max=86). The
mean pain score was 8,17±2,45 (min=0, max=10) in the last 24 hours, and the
slightest pain score in the last 24 hours was 3,16±2,18. The mean hospital
anxiety and depression scores of elderly patients undergoing arthroplasty
surgery were 11,48±5,36 and 8,74±5,25, respectively. There was a statistically
significant difference between the mean scores of the pain severity (current)
according to the presence of anxiety in elderly patients (t=-2,05; p=0,04).
There was no statistically significant difference between gender, educational
status, operation and depression and pain severity (present) (p> 0,05).
Patients who had total knee arthroplasty had significantly higher pain severity
than patients who underwent total hip arthroplasty. (t=4,01, p=0,00).

 

Conclusion: Elderly patients
with arthroplasty had severe postoperative pain. Elderly people may experience
less pain with combined therapy for pain management in elderly patients.
Managing anxiety in preoperative and postoperative can reduce pain. Therefore,
it may be recommended to give preoperative training to elderly patients.















 

References

  • 1. Etzioni DA, Liu JH, Maggard MA, ve ark. The aging population and its impact on the surgery workforce. Annals of Surgery, 2003; 238: 170–7.
  • 2. Hamel MB, Henderson WG, Khuri SF, ve ark. Surgical outcomes for patients aged 80 and older: morbidity and mortality from major noncardiac surgery. Journal of the American Geriatrics Society,2005; 53: 424–9
  • 3. Barnett K, Mercer SW, Norbury M, ve ark. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet, 2012; 380: 37–43.
  • 4. Pasero C, McCaffery M. Orthopaedic postoperatif pain management. Journal of PeriAnesthesia Nursing, 2007;22(3): 160-174.
  • 5. Schoen DC. Pain in the orthopaedic patient. Orthopaedic Nursing, 2007; 26(2): 140–144. doi: 10.1097/01.NOR.0000265875.02760.f6
  • 6. Shyu Y, Chen ML, Chen MC, ve ark. Postoperative pain and its impact on quality of life for hip-fractured older people over 12 months after hospital discharge, Journal of Clinical Nursing, 2009; 18(5): 755-64. doi: 10.1111/j.1365-2702.2008.02611.x.
  • 7. Demir Y. Non-pharmacoogical terapies in pain management. Pain Management-Current Issues and Opinions. Racz, G. (Ed.), ISBN:978-953-307-813-7, Publisher InTech, Chapter 2012;23: 485-502. http://cdn.intechopen.com/pdfs-wm/26152.pdf,
  • 8. Botti M, Bucknall T, Manias E. The problem of postoperative pain: issues for future research. International Journal of Nursing Practice, 2004;10(6): 257-263.
  • 9. Eti Aslan F, Badır A. Ağrı kontrol gerçeği: Hemşirelerin ağrının doğası, değerlendirilmesi ve geçirilmesine ilişkin bilgi ve inançları. Ağrı,2005; 17(2): 44-51.
  • 10. Richards J, Hubbert AO. Experiences of expert nurses in caring for patients with postoperative pain. Pain Management Nursing, 2007; 8(1): 17-24.
  • 11. Girdhari S, Smith SK. Assisting older adults with orthopaedic outpatient acute-pain management. Orthopaedic Nursing, 2006; 25(3): 188-195.
  • 12. Özyalçın S, Dinçer S. Yaşlılarda ağrı. Klinik Gelişim, 2007; 20(3): 69-140.
  • 13. Ay F, Alpar SE. Postoperatif ağrı ve hemşirelik uygulamaları, Ağrı,2010; 22(1): 21-29.
  • 14. Grinstein-Cohen O, Sarid O, Attar D, ve ark. Improvements and difficulties in postoperative pain management. Orthopaedic Nursing, 2009; 28(5): 232-239.
  • 15. Dicle A, Karayurt O, Dirimese E. Validation of the Turkish version of the brief pain inventory in surgery. Pain Management Nursing 2009;10(2):107-113.
  • 16. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica, 1983; 67(6): 361-370.
  • 17. Aydemir Ö. Hastane anksiyete depresyon ölçeği türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi 1997; 8(4):280-287.
  • 18. Kim HS, Schwartz-Barcott D, Tracy SM, ve ark. Strategies of pain assessment used by nurses on surgical units. Pain Management Nursing, 2005;6(1):3-9.
  • 19. Vargas-Schaffer G, Cogan J. Patient therapeutic education. Placing the patient at the centre of the WHO analgesic ladder. Canadian Family Physician, 2014; 60: 235-241.
  • 20. Vargas-Schaffer G. Is the WHO analgesic ladder still valid? Canadian Family Physician, 2010; 56; 514-517
  • 21. Manias E, Bucknall T, Botti M. (Nurses' strategies for managing pain in the postoperative setting. Pain Management Nursing, 2005;6(1): 18-29.
  • 22. Berde C, Nurko S. Opioid side effects--mechanism-based therapy. The New England Journal of Medicine, 2008; 358(22): 2400-2402. doi: 10.1056/NEJMe0801783.
  • 23. Cashman JN, Dolin SJ. Respiratory and haemodynamic effects of acute postoperative pain management: evidence from published data. British Journal of Anaesthesia, 2004; 93(2): 212-23.
  • 24. Donoghue OA, Ryan H, Duggan E, ve ark. Relationship between fear of falling and mobility varies with visual function among older adults. Geriatr Gerontol Int 2014; 14: 827–836.
  • 25. Lin LY, Wang RH. Abdominal surgery, pain and anxiety: preoperative nursing intervention. Journal of Advanced Nursing, 2005; 51(3): 252-260.
  • 26. Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. Journal of Clinical Nursing, 2015; 24(1-2): 34-46.
  • 27. Bruce J, Thornton AJ, Scott NW, ve ark. Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. British journal of cancer, 2012; 107(6): 937.
  • 28. Bell L, Duffy A. Pain assessment and management in surgical nursing: A literature review. British Journal of Nursing, 2009; 18(3), 153–156.
  • 29. Bray A. Preoperative nursing assessment of the surgical patient. Nursing Clining of North America, 2006; 41(2): 135-50.

Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler

Year 2018, Volume: 1 Issue: 3, 104 - 112, 31.12.2018

Abstract

Amaç: Bu çalışmanın amacı, artroplasti ameliyatı
olan yaşlı hastaların yaşadıkları ağrı şiddeti ve etkileyen faktörleri
incelemektir.

 

Gereç ve
Yöntemler:
Bu
araştırma kesitsel tanımlayıcıdır. Veriler Şubat 2014-Nisan 2015 arasında bir
üniversite hastanesinin Ortopedi ve Travmatoloji Kliniğinde toplanmıştır.
Verilerin toplanmasında “Sosyodemografik ve Klinik Özellikler Formu”, “Kısa
Ağrı Envanteri” ve “Hastane Anksiyete Depresyon Ölçeği” kullanılmıştır.
Örnekleme çalışmaya katılmayı kabul eden 128 yaşlı hasta dâhil edilmiştir. Etik
kurul ve kurum izni ile hasta onamı alınmıştır. 

 

Bulgular: Çalışmadaki artroplasti ameliyatı olan yaşlı
hastaların yaş ortalaması 71,05±6.21 (min=65, max=86) olup, katılımcıların
%75,0’i kadın, %48,4’ü ilköğretim mezunu, %54,7’si total kalça artroplasti
ameliyatı olmuştur. Araştırmaya katılan hastaların son 24 saat içinde en kötü
ağrı puan ortalamasının 8,17±2,45 (min=0, max=10), son 24 saatte en hafif ağrı
puan ortalamasının 3,16±2,18 (min=0, max=8) olduğu belirlenmiştir. Artroplasti
ameliyatı geçiren yaşlı hastaların hastane anksiyete ve depresyon puan
ortalamaları sırasıyla 11,48±5,36 ve 8,74±5,25’dir. Ameliyat sonrası yaşlı
hastaların anksiyete varlığına göre ağrı şiddeti (şu andaki)  puan ortalaması arasında istatistiksel olarak
anlamlı fark olduğu saptanmıştır (t=-2,05; p=0,04). Cinsiyet, eğitim durumu,
yapılan ameliyat ve depresyon varlığı ile ağrı şiddeti (şu andaki) arasında istatistiksel
olarak anlamlı bir fark olmadığı belirlenmiştir (p>0,05). Total diz artroplastisi
yapılan hastaların total kalça artroplastisi yapılanlara göre ağrı şiddeti istatistiksel
olarak anlamlı olarak daha yüksektir (t=4,01, p=0,00).

 

Sonuç: Artroplasti ameliyatı olan yaşlı hastaların
ameliyat sonrası şiddetli ağrı yaşadıkları saptandı. Yaşlı hastaların ağrı
yönetiminde kombine tedavi kullanılması ile yaşlılar daha az ağrı yaşayabilir.
Ameliyat öncesi ve sonrasında anksiyeteyi yönetmek ağrıyı azaltabilir. Bu
nedenle yaşlı hastaların ameliyat öncesi eğitimlerinde etkili ağrı yönetimine yer
verilmesi önerilebilir.















 

References

  • 1. Etzioni DA, Liu JH, Maggard MA, ve ark. The aging population and its impact on the surgery workforce. Annals of Surgery, 2003; 238: 170–7.
  • 2. Hamel MB, Henderson WG, Khuri SF, ve ark. Surgical outcomes for patients aged 80 and older: morbidity and mortality from major noncardiac surgery. Journal of the American Geriatrics Society,2005; 53: 424–9
  • 3. Barnett K, Mercer SW, Norbury M, ve ark. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet, 2012; 380: 37–43.
  • 4. Pasero C, McCaffery M. Orthopaedic postoperatif pain management. Journal of PeriAnesthesia Nursing, 2007;22(3): 160-174.
  • 5. Schoen DC. Pain in the orthopaedic patient. Orthopaedic Nursing, 2007; 26(2): 140–144. doi: 10.1097/01.NOR.0000265875.02760.f6
  • 6. Shyu Y, Chen ML, Chen MC, ve ark. Postoperative pain and its impact on quality of life for hip-fractured older people over 12 months after hospital discharge, Journal of Clinical Nursing, 2009; 18(5): 755-64. doi: 10.1111/j.1365-2702.2008.02611.x.
  • 7. Demir Y. Non-pharmacoogical terapies in pain management. Pain Management-Current Issues and Opinions. Racz, G. (Ed.), ISBN:978-953-307-813-7, Publisher InTech, Chapter 2012;23: 485-502. http://cdn.intechopen.com/pdfs-wm/26152.pdf,
  • 8. Botti M, Bucknall T, Manias E. The problem of postoperative pain: issues for future research. International Journal of Nursing Practice, 2004;10(6): 257-263.
  • 9. Eti Aslan F, Badır A. Ağrı kontrol gerçeği: Hemşirelerin ağrının doğası, değerlendirilmesi ve geçirilmesine ilişkin bilgi ve inançları. Ağrı,2005; 17(2): 44-51.
  • 10. Richards J, Hubbert AO. Experiences of expert nurses in caring for patients with postoperative pain. Pain Management Nursing, 2007; 8(1): 17-24.
  • 11. Girdhari S, Smith SK. Assisting older adults with orthopaedic outpatient acute-pain management. Orthopaedic Nursing, 2006; 25(3): 188-195.
  • 12. Özyalçın S, Dinçer S. Yaşlılarda ağrı. Klinik Gelişim, 2007; 20(3): 69-140.
  • 13. Ay F, Alpar SE. Postoperatif ağrı ve hemşirelik uygulamaları, Ağrı,2010; 22(1): 21-29.
  • 14. Grinstein-Cohen O, Sarid O, Attar D, ve ark. Improvements and difficulties in postoperative pain management. Orthopaedic Nursing, 2009; 28(5): 232-239.
  • 15. Dicle A, Karayurt O, Dirimese E. Validation of the Turkish version of the brief pain inventory in surgery. Pain Management Nursing 2009;10(2):107-113.
  • 16. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica, 1983; 67(6): 361-370.
  • 17. Aydemir Ö. Hastane anksiyete depresyon ölçeği türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi 1997; 8(4):280-287.
  • 18. Kim HS, Schwartz-Barcott D, Tracy SM, ve ark. Strategies of pain assessment used by nurses on surgical units. Pain Management Nursing, 2005;6(1):3-9.
  • 19. Vargas-Schaffer G, Cogan J. Patient therapeutic education. Placing the patient at the centre of the WHO analgesic ladder. Canadian Family Physician, 2014; 60: 235-241.
  • 20. Vargas-Schaffer G. Is the WHO analgesic ladder still valid? Canadian Family Physician, 2010; 56; 514-517
  • 21. Manias E, Bucknall T, Botti M. (Nurses' strategies for managing pain in the postoperative setting. Pain Management Nursing, 2005;6(1): 18-29.
  • 22. Berde C, Nurko S. Opioid side effects--mechanism-based therapy. The New England Journal of Medicine, 2008; 358(22): 2400-2402. doi: 10.1056/NEJMe0801783.
  • 23. Cashman JN, Dolin SJ. Respiratory and haemodynamic effects of acute postoperative pain management: evidence from published data. British Journal of Anaesthesia, 2004; 93(2): 212-23.
  • 24. Donoghue OA, Ryan H, Duggan E, ve ark. Relationship between fear of falling and mobility varies with visual function among older adults. Geriatr Gerontol Int 2014; 14: 827–836.
  • 25. Lin LY, Wang RH. Abdominal surgery, pain and anxiety: preoperative nursing intervention. Journal of Advanced Nursing, 2005; 51(3): 252-260.
  • 26. Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. Journal of Clinical Nursing, 2015; 24(1-2): 34-46.
  • 27. Bruce J, Thornton AJ, Scott NW, ve ark. Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. British journal of cancer, 2012; 107(6): 937.
  • 28. Bell L, Duffy A. Pain assessment and management in surgical nursing: A literature review. British Journal of Nursing, 2009; 18(3), 153–156.
  • 29. Bray A. Preoperative nursing assessment of the surgical patient. Nursing Clining of North America, 2006; 41(2): 135-50.
There are 29 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Hale Turhan Damar

Özlem Bilik

Publication Date December 31, 2018
Submission Date December 4, 2018
Acceptance Date December 31, 2018
Published in Issue Year 2018 Volume: 1 Issue: 3

Cite

APA Turhan Damar, H., & Bilik, Ö. (2018). Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler. Geriatrik Bilimler Dergisi, 1(3), 104-112.
AMA Turhan Damar H, Bilik Ö. Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler. JoGS. December 2018;1(3):104-112.
Chicago Turhan Damar, Hale, and Özlem Bilik. “Artroplasti Ameliyatı Olan Yaşlı Hastaların Ağrı Düzeyi Ve Etkileyen Faktörler”. Geriatrik Bilimler Dergisi 1, no. 3 (December 2018): 104-12.
EndNote Turhan Damar H, Bilik Ö (December 1, 2018) Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler. Geriatrik Bilimler Dergisi 1 3 104–112.
IEEE H. Turhan Damar and Ö. Bilik, “Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler”, JoGS, vol. 1, no. 3, pp. 104–112, 2018.
ISNAD Turhan Damar, Hale - Bilik, Özlem. “Artroplasti Ameliyatı Olan Yaşlı Hastaların Ağrı Düzeyi Ve Etkileyen Faktörler”. Geriatrik Bilimler Dergisi 1/3 (December 2018), 104-112.
JAMA Turhan Damar H, Bilik Ö. Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler. JoGS. 2018;1:104–112.
MLA Turhan Damar, Hale and Özlem Bilik. “Artroplasti Ameliyatı Olan Yaşlı Hastaların Ağrı Düzeyi Ve Etkileyen Faktörler”. Geriatrik Bilimler Dergisi, vol. 1, no. 3, 2018, pp. 104-12.
Vancouver Turhan Damar H, Bilik Ö. Artroplasti Ameliyatı olan Yaşlı Hastaların Ağrı Düzeyi ve Etkileyen Faktörler. JoGS. 2018;1(3):104-12.

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