Perspectives on the nursing management of osteoarthritis

How nursing personnel judge patients’ pain

The study examined how nurses, student nurses, and nurse's aides judge patients' level of pain from five indicators: facial grimacing, maintenance of abnormal body position, restriction of movement, complaints about pain, and signs of possible depression. In Toulouse, France, 214 participants were presented with 48 vignettes describing an elderly patient suffering from osteoarthritis who showed various levels of these signs. The three most important factors in judging pain were the difficulty in making social contact with the patient, the patient's avoidance of changing position, and her avoidance of movements. The nurses put more emphasis on the difficulty in making social contact than did the student nurses and nurse's aides. In all groups, each sign of pain contributed independently and additively to the level of pain that the patient was thought to be experiencing.

The impact of nurse prescribing on patients with osteoarthritis

Osteoarthritis (OA) is now considered one of the ten most disabling diseases in developed countries and it is estimated that worldwide, 18% of women and 9.6% of men aged over 60, suffer from OA. It is, therefore, vital to take into consideration the demographics of this disorder, including the health needs of this age group and associated problems, such as reduced mobility or immobility and the inability to perform everyday tasks associated with chronic pain. Older patients, however, are sometimes able to accept their condition and adopt a positive outlook towards their OA as a coping strategy. This association with and acceptance of pain by the patient as a normal part of the ageing process may compromise the patient's ability to undertake activities of daily living and impact their psychological wellbeing.

The effect of heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis

AIMS AND OBJECTIVES

The aim in this study was to evaluate the effect of local heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis.

BACKGROUND

Local heat application is used as a non-pharmacological practice for the treatment of knee osteoarthritis. On the other hand, literature reveals limited information on the effects of heat application.

DESIGN

The study was a comparative study.

METHODS

The patients with knee osteoarthritis were divided into two groups (23 patients in each) as intervention and control groups, and patients in the control group were applied with the routine medication of the physician. The intervention group received 20-minute heat application every other day for four weeks in addition to the routine medication. The data were collected using data collection form, Western Ontario and McMaster Universities Index and SF-36.

RESULTS

The Western Ontario and McMaster Universities pain and Western Ontario and McMaster Universities disability scores of the patients with knee osteoarthritis in control and intervention groups before and after the intervention were compared, and the differences for both scores in the change were found to be statistically significant (p < 0.05). Moreover, statistically significant differences were found between the control and intervention group patients in terms of changes in the scores for physical function, pain and general health perception (p < 0.05).

CONCLUSIONS

It was found that heat application every other day decreased pain and disability of the patients with knee osteoarthritis. Also, heat application was found to improve the subdimensions of quality of life scores of physical function, pain and general health perception of patients.

RELEVANCE TO CLINICAL PRACTICE

The data obtained in this study on the efficiency of heat application on pain, stiffness, physical function and general health perception of patients with knee osteoarthritis may offer an insight into decision-making process for appropriate intervention.

Evaluating the Effects of an Educational Symposium on Knowledge, Impact, and Self-Management of Older African Americans Living With Osteoarthritis

The purpose of the study1 was to determine the effects of a 1-day educational symposium on knowledge, impact, and self-management of older African Americans living with osteoarthritis (OA). A 1-group pre- and posttest design was employed. The educational symposium was the intervention variable. Speakers were experts in the field of arthritis care. Participants were recruited from a community senior center. Participants completed the Short Form of the Arthritis Impact Management Scales (AIMS2-SF), the Summary of Arthritis Management Methods (SAMMS), and a 6-question Knowledge Test about OA before the symposium. The knowledge test was administered again at the completion of the program. Posttesting of the AIMS2-SF and SAMMS occurred 3 months later to assess changes in arthritis impact and self-management strategies. Knowledge scores increased significantly immediately following the symposium. The AIMS2-SF subscales of Affect, Symptom, and Physical Function decreased significantly 3 months after the symposium indicating that arthritis had less impact on participants after the conference. Participants also reported using more self-management methods 3 months after the event. The results of this pilot study indicate that this symposium was effective in increasing participants' knowledge of OA, improving self-management, and decreasing the impact of OA on daily function. The small sample size and preexperimental design limit generalizability.