Total kalça protezi olan hastaların ağrı, hareket ve düşme korkusunun günlük yaşam aktivitelerine etkisi
Abstract
Bu tez çalışması total kalça protezi yapılan hastaların, ağrı hareket ve düşme korkusunun günlük yaşam aktivitelerine etkisinin incelenmesi amacıyla tanımlayıcı ve kesitsel olarak yapıldı. Araştırma, İstanbul Üniversitesi İstanbul Tıp Fakültesi Hastanesi ortopedi ve travmatoloji kliniğinde 29.01.2020-15.09.2021 tarihleri arasında total kalça protezi uygulanan 121 hasta ile gerçekleştirildi. Araştırma verileri 'Hasta Tanıtım formu', 'Görsel Analog Skala (Visual Analogue Scale –VAS)', 'Barthel Günlük Yaşam Aktiviteleri İndeksi (BGYAİ)', 'Tampa Kinezyofobi Ölçeği (TKÖ)', 'Tinetti Düşme Etkinlik Ölçeği (TDEÖ)' kullanılarak toplandı. Hastalardan elde edilen verilerin istatistiksel analizleri R vers. 2.15.3 programı (R Core Team, 2013) kullanılarak yapıldı. Çalışma verilerinin raporlanmasında tanımlayıcı istatistikler (minimum, maksimum, ortalama, standart sapma, medyan, birinci çeyreklik, üçüncü çeyreklik, sıklık ve yüzde) ve Shapiro-Wilk testi, Mann-Whitney U testi, Kruskal-Wallis testi, Dunn-Bonferroni testi, Pearson korelasyon analizi, Cronbach alfa katsayısı ve çok değişkenli lineer regresyon analizi kullanıldı. Araştırmaya alınan hastaların yaş ortalamasının 61,16±13,75, %65,3'ünün kadın, %65,3'ünün koksartroz tanısı konulduğu, tüm hastaların TKP sonrası hareket etmesini azaltan/engelleyen en az bir tane kısıtlayıcı durum olduğu, bu durumun da %80,2 oranında ağrı olduğu belirlendi. Hastaların VAS puan ortalamaları ameliyat öncesi 5,61±3,34, ameliyat sonrası 3,76±1,46 BYGAİ puan ortalaması ameliyat öncesi 80,33±21,32, ameliyat sonrası 66,90±24,68, olduğu saptandı. Ameliyat sonrası TDEÖ puan ortalaması 53,73±17,64, TKÖ puan ortalaması 44,96±8,09 olarak bulundu. Ameliyat sonrası BGYAİ puanları ile TDEÖ (p<0,001) puanları arasında pozitif yönde, TDEÖ puanları ile TKÖ puanları (p<0,001) ile negatif yönde istatistiksel olarak anlamlı ilişki olduğu, ameliyat sonrası VAS puanında gerçekleşen 1 birimlik artışın BGYAİ AS puanında 6,517 birim (puan) düşüşe neden olduğu (p<0,001), TDEÖ puanında gerçekleşen 1 birimlik artışın BGYAİ AS puanında 0,700 birim artışa neden olduğu (p<0,001) ve kronik hastalık varlığının BGYAİ AS puanında 16,533 birim (puan) düşüşe neden olduğu saptandı (p<0,001). Hemşireler, total kalça protezi uygulanan hastalarının günlük yaşam aktivitelerini iyileştirmek için gerekli hemşirelik uygulamalarını gerçekleştirmelidir.
This study was conducted as a descriptive and cross-sectional study in order to examine the effects of pain, movement and fear of falling on the activities of daily living in patients who underwent total hip replacement. The study was carried out with 121 patients who were hospitalized in the orthopedic clinic of Istanbul University Istanbul Medical Faculty Hospital and underwent total hip replacement between the dates of 29.01.2020-15.09.2021. The data of the study were collected using 'Patient Description Form', 'Visual Analogue Scale (VAS)', 'Barthel Activities of Daily Living Index (BADLI)', 'Tampa Kinesiophobia Scale (TKS)', Tinetti Fall Efficiency Scale (TFES). The statistical analyzes of data obtained from patients were made using a computer programme called R vers. 2.15.3 (R Core Team, 2013) Descriptive statistics (min, maximum, mean, standard deviation, median, first quartile, third quartile, frequency, and percentage) and Shapiro-Wilk test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, Pearson in reporting study data correlation analysis, Cronbach's alpha coefficient and multivariate linear regression analysis were used. The mean age of the patients included in the study was 61.16±13.75, 65.3% were female, 65.3% had a diagnosis of coxarthrosis and 100% had decreased/prevented movement after THR. There was at least one limiting condition, 80.2% of those were pain. The mean VAS score of the patients was 5.61±3.34 preoperatively, 3.76±1.46 postoperatively. The mean BADLI score of the patients was 80.33±21.32 preoperatively and 66.90±24.68 postoperatively. The mean postoperative TDI score was 53.73±17.64, and the mean TSK score was 44.96±8.09. There was a statistically significant positive correlation between postoperative BADLI scores and TFES scores (p<0.001), and a statistically significant negative correlation between TFES scores and TKS scores (p<0.001), and a 1-unit increase in the postoperative VAS score caused a 6.517 units decrease in BADLAI AS score (p<0.001), a 1-unit increase in the TFES score led to an increase of 0.700 units in the BADLAI AS score (p<0.001) and the presence of chronic disease caused a decrease of 16,533 units (points) in the BADLAI AS score (p<0.001). Nurses should perform the necessary nursing practices to improve the daily living activities of patients who have undergone total hip replacement.
This study was conducted as a descriptive and cross-sectional study in order to examine the effects of pain, movement and fear of falling on the activities of daily living in patients who underwent total hip replacement. The study was carried out with 121 patients who were hospitalized in the orthopedic clinic of Istanbul University Istanbul Medical Faculty Hospital and underwent total hip replacement between the dates of 29.01.2020-15.09.2021. The data of the study were collected using 'Patient Description Form', 'Visual Analogue Scale (VAS)', 'Barthel Activities of Daily Living Index (BADLI)', 'Tampa Kinesiophobia Scale (TKS)', Tinetti Fall Efficiency Scale (TFES). The statistical analyzes of data obtained from patients were made using a computer programme called R vers. 2.15.3 (R Core Team, 2013) Descriptive statistics (min, maximum, mean, standard deviation, median, first quartile, third quartile, frequency, and percentage) and Shapiro-Wilk test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, Pearson in reporting study data correlation analysis, Cronbach's alpha coefficient and multivariate linear regression analysis were used. The mean age of the patients included in the study was 61.16±13.75, 65.3% were female, 65.3% had a diagnosis of coxarthrosis and 100% had decreased/prevented movement after THR. There was at least one limiting condition, 80.2% of those were pain. The mean VAS score of the patients was 5.61±3.34 preoperatively, 3.76±1.46 postoperatively. The mean BADLI score of the patients was 80.33±21.32 preoperatively and 66.90±24.68 postoperatively. The mean postoperative TDI score was 53.73±17.64, and the mean TSK score was 44.96±8.09. There was a statistically significant positive correlation between postoperative BADLI scores and TFES scores (p<0.001), and a statistically significant negative correlation between TFES scores and TKS scores (p<0.001), and a 1-unit increase in the postoperative VAS score caused a 6.517 units decrease in BADLAI AS score (p<0.001), a 1-unit increase in the TFES score led to an increase of 0.700 units in the BADLAI AS score (p<0.001) and the presence of chronic disease caused a decrease of 16,533 units (points) in the BADLAI AS score (p<0.001). Nurses should perform the necessary nursing practices to improve the daily living activities of patients who have undergone total hip replacement.
Description
Keywords
Hemşirelik, Ağrı, Düşme kazaları, Günlük yaşam aktiviteleri, Nursing, Pain, Hareket, Accidental falls, Activities of daily living, Hareket korkusu, Motion, Kalça eklemi, Kinesiophobia, Hip joint, Kalça protezi, Hip prosthesis