1
|
Wang C, Tan B, Qian Q. The impact of perioperative enhanced recovery nursing model on postoperative delirium and rehabilitation quality in elderly patients with femoral neck fractures. BMC Musculoskelet Disord 2023; 24:947. [PMID: 38057753 DOI: 10.1186/s12891-023-07068-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the effects of introducing the Enhanced Recovery After Surgery (ERAS) nursing model on postoperative delirium occurrence and rehabilitation quality in elderly patients with femoral neck fractures. METHODS A total of 160 elderly patients with femoral neck fractures, who met the inclusion criteria and were admitted between March 2021 to March 2023, were divided into two groups: the traditional care group and the ERAS nursing model group. In addition to traditional care measures, the ERAS nursing model group received interventions based on the principles of the ERAS nursing model. The occurrence of delirium and sleep quality were observed at 24, 48, and 72 h postoperatively, as well as during the overall hospital stay. The duration of hospitalization, time to first mobilization, and post-discharge follow-up on quality of life were compared between the two groups. RESULTS The ERAS nursing model group exhibited a significant difference in the occurrence of delirium at 48 and 72 h postoperatively, as well as during the overall hospital stay (P < 0.05). However, there was no significant difference in the occurrence of delirium at 24 h postoperatively (P > 0.05). The sleep quality of the two groups showed a statistically significant difference (P < 0.05). The ERAS nursing model group had shorter time to first mobilization, reduced hospitalization duration, and higher Harris and SF-36 scores during post-discharge follow-up, compared to the traditional care group (P < 0.05). CONCLUSIONS The implementation of the ERAS nursing model in elderly patients with femoral neck fractures improved postoperative sleep quality, reduced delirium occurrence, shortened average hospitalization duration, and enhanced patients' quality of life.
Collapse
Affiliation(s)
- Cheng Wang
- Department of Orthopedics, Wuhan Fourth Hospital, No. 473, Hanzheng Street, Qiaokou District, Wuhan, 430033, China
| | - Bingyin Tan
- Department of Pharmacy, Wuhan Fourth Hospital, No. 473, Hanzheng Street, Qiaokou District, Wuhan, 430033, China
| | - Qing Qian
- Department of Orthopedics, Wuhan Fourth Hospital, No. 473, Hanzheng Street, Qiaokou District, Wuhan, 430033, China.
| |
Collapse
|
2
|
Gylvin SH, Fink-Jensen A, Kehlet H, Jørgensen CC, Laursen MB, Gromov K, Schroder HM, Høvsgaard SJ, Wede HR, Kyle PR, Bech P. Prospective psychometric characterization of hip and knee arthroplasty patients. Nord J Psychiatry 2018; 72:39-44. [PMID: 29022751 DOI: 10.1080/08039488.2017.1381149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Psychiatric conditions and psychopharmacological treatments have been demonstrated to be important risk-factors for prolonged hospital length of stay, readmission and morbidity, following fast-track total hip (THA) and total knee arthroplasty (TKA). AIMS The aim of the study was to provide a detailed description of the preoperative psychiatric characteristics of a well-defined patient population undergoing THA and TKA, using the 90-item Symptom Checklist (SCL-90-R). METHODS A pre-surgical population of 2183 patients completed the full SCL-90-R prior to THA/TKA from 2015 to 2016. The SCL-90-R scale and total scores of the pre-surgical sample were compared to the scores of an age- and gender stratified Danish sample of healthy controls. A Mokken scalogram analysis was conducted to assess the scalability of the SCL-90-R in both samples. RESULTS The Mokken analysis yielded acceptable scalability coefficients above 0.30 in all subscales of the SCL-90-R except psycoticism (0.28). There was no clinically significant difference (effect size = <0.50) in the SCL-90-R total score between the pre-surgical and the healthy controls samples, although pre-surgical patients had lower mean scores compared to the healthy controls in all subscales except somatization (effect size = -0.22). CONCLUSION The Mokken analysis demonstrated that the SCL-90-R and its subscales express valid measures of psychopathology in our surgical sample. The psychiatric profile of the pre-surgical patient sample indicates that patients undergoing THA/TKA are not more burdened by psychiatric symptoms than a healthy control group with the exception of symptoms relating to somatization.
Collapse
Affiliation(s)
- Silas Hinsch Gylvin
- a Section of Surgical Pathophysiology , Rigshospitalet , Kobenhavn , Denmark.,b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark
| | - Anders Fink-Jensen
- c Psychiatric Centre Copenhagen and Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology , University of Copenhagen , Copenhagen , Denmark
| | - Henrik Kehlet
- a Section of Surgical Pathophysiology , Rigshospitalet , Kobenhavn , Denmark.,b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark
| | - Christoffer Calov Jørgensen
- a Section of Surgical Pathophysiology , Rigshospitalet , Kobenhavn , Denmark.,b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark
| | - Mogens Berg Laursen
- b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark.,d Department of Orthopedic Surgery , Aalborg University Hospital , Farsø , Denmark
| | - Kirill Gromov
- b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark.,e Department of Orthopedic Surgery , Copenhagen University Hospital , Hvidovre , Denmark
| | - Henrik Morville Schroder
- b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark.,f Department of Orthopaedic Surgery , Naestved Hospital , Naestved , Denmark
| | - Susanne Jung Høvsgaard
- b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark.,g Section for Hip and Knee Replacement , Vejle Hospital , Vejle , Denmark
| | - Heidi Raahauge Wede
- b Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty , Kobenhavn , Denmark.,h Department of Orthopedic Surgery , Gentofte Hospital , Gentofte , Denmark
| | - Phillip Raphael Kyle
- i Psychiatric Research Unit , Psychiatric Centre North Zealand, University of Copenhagen , Hillerød , Denmark
| | - Per Bech
- i Psychiatric Research Unit , Psychiatric Centre North Zealand, University of Copenhagen , Hillerød , Denmark
| |
Collapse
|