Total diz protezi uygulanan hastaların bireysel bakım algısının iyilik hallerine etkisi
Abstract
Bu araştırma ortopedi ve travmatoloji servislerinde total diz protezi uygulanan hastaların bireysel bakım algısının iyilik hallerine etkisini belirlemek amacı ile tanımlayıcı olarak yapıldı. Araştırma İstanbul Üniversitesi İstanbul Tıp Fakültesi Hastanesi ortopedi ve travmatoloji servislerinde 06.01.2021- 09.10.2021 tarihleri arasında total diz protezi uygulanan 149 hasta ile gerçekleştirildi. Araştırma verileri, 'Hasta Bilgi Formu', 'Bireyselleştirilmiş Bakım Skalası-B' ve 'İyileşme Kalitesi-40 Ölçeği' kullanılarak elde edildi. Hastalardan elde edilen verilerin istatistiksel analizleri SPSS (Statistical Packet for The Social Science) 25.0 paket programında yapıldı. Verilerin analizinde tanımlayıcı istatikler (minimum, maksimum, ortalama, standart sapma, medyan, birinci çeyreklik, üçüncü çeyreklik, sıklık ve yüzde) ve Shapiro-Wilk testi, Bağımsız gruplar t testi, Mann-Whitney U, Kruskall Wallis, Dunn-Bonferroni, Pearson korelasyon analizi ve lojistik regresyon analizi kullanıldı. Hastaların yaş ortalaması 66,74±7,12, %73,2'sinin kadın, %71,1'inin evli, %62,4'ünün ilkokul mezunu, hastanede yatış süreleri ortalaması 5,73±1,65 olduğu belirlendi. Araştırma kapsamındaki hastaların %49'unu sağ gonartroz tanılı hastaların oluşturduğu görüldü. Hastaların %51'inin kronik hastalığı olmadığı, %57,7'sinin daha önce hastaneye yatma öyküsü bulunduğu, %82,6'sına lokal anestezi uygulandığı, lokal anestezi uygulanan hastaların %65,9'una spinal anestezi uygulandığı tespit edildi. Hastaların bireysel bakım algılama düzeyleri toplam puan ortalamaları 4.60±0,37, alt boyutları puan ortalamaları sırasıyla 'Klinik durum' 4,72±0,40 olarak, 'Kişisel yaşam durumu' 4,64±0,53 olarak, 'Karar verme kontrolü' 4,43±0,36 olduğu belirlendi. Hastaların İyileşme Kalitesi Ölçeği toplam puan ortalaması 181,72±13,49 olarak, alt boyutları puan ortalamaları ise 'Fiziksel rahatlık' 53,62±4,89 olarak, 'Duygusal durum' 41,44±3,22 olarak, 'Fiziksel bağımsızlık' 20,19±3,33 olarak, 'Hasta desteği' 34,17±1,74 olarak ve 'Ağrı' 32,3±3,62 olarak belirlendi. Hastaların Bireysel bakım algılama düzeyi ve tüm alt boyut puan ortalamaları ile İyileşme kalitesi düzeyi ve tüm alt boyut puan ortalamaları arasındaki korelasyonda pozitif yönde istatistiksel olarak anlamlı ilişki olduğu saptandı. Bireysel bakım algısı toplam puanında gerçekleşen bir puanlık artışın İyileşme kalitesi düzeyi toplam puanında 1.088 puan artışa neden olduğu saptandı. Total diz protezi uygulanan hastaların bireysel bakım algılama düzeyleri ve İyileşme kalitesi düzeylerinin yüksek olduğu belirlendi. Bireysel bakım algılama düzeyi arttıkça iyileşme kalitesi düzeyinin de arttığı belirlendi. Bakım bireyselleştirildiğinde, bireye en uygun olan bakım verildiğinde olumlu hasta sonuçları oluşmakta, hastaların iyileşme kaliteleri, iyilik halleri olumlu etkilenmektedir.
This descriptive study was conducted to determine the effect of individual care perception on the recovery quality of patients who underwent total knee arthroplasty in orthopedics and traumatology services. The research was carried out with 149 patients who underwent total knee arthroplasty in the orthopedics and traumatology services of Istanbul University Istanbul Medical Faculty Hospital between the dates 06.01.2021 and 09.10.2021. The data of the study were collected 'Patient Information Form', 'Individualized Care Scale-B', 'Quality of Recovery-40 Questionnaire (QoR-40)'. Statistical analyzes of the data obtained from the patients were performed in the SPSS (Statistical Packet for The Social Science) 25.0 package program. Descriptive tests in data analysis (minimum, maximum, mean, median, standard deviation, first quartile, third quartile, frequency and percentage), Shapiro-Wilk test, Independent groups t test, Mann-Whitney U, Kruskal Wallis Test, Dunn -Bonferroni, Pearson correlation analysis and logistic regression analysis were used. The mean age of the patients included in the study was 66,74±7,12, 73,2% were female, 71,1% were married, 38% were primary school graduates, and the average lenght of hospital stay was 5,73±1,65. It was observed that 49% of the patients in the study consisted of patients with a diagnosis of right gonarthrosis. It was determined that 51% of the patients did not have a chronic disease, 57,7% had a history of hospitalization before, 82,6% of them were administered local anesthesia, and 65,9% of the patients who were administered local anesthesia were administered spinal anesthesia. Individual care perception levels of the patients, mean total score were determined to be 4,60±0,37, sub-dimensions mean scores, respectively 'Clinical situation' was determined to be 4,72±0,40, 'Personal life situation' was determined to be 4,64±0,53, 'Decision control' was determined to be 4,43±0,36. The total mean score of the QoR-40 scale of the patients was determined to be 181,72±13,49, sub-dimensions mean scores 'Physical comfort' were determined to be as 53,62±4,89, 'Emotional situation' was determined to be as 41,44±3,22, 'Physical independence' was determined to be as 20,19±3,33, 'Patient support' was determined to be as 34,17±1,74 and 'Pain' was determined to be as 32,3±3,62. A statistically significant positive correlation was found in the correlation between the patients level of individual care perception and all sub-dimension mean scores, and the quality of recovery and all sub-dimension mean scores. It was determined that a one-point increase in the total score of the individual care perception caused an increase of 1.088 points in the total score of the quality of recovery. It was determined that the patients who underwent total knee arthroplasty had high levels of individual care perception and quality of recovery. It was determined that as the level of individual care perception increased, the level of quality of recovery increased as well. When the care is individualized and the most appropriate care is given to the individual, positive patient outcomes occur, and the quality of recovery and well-being of the patients are positively affected.
This descriptive study was conducted to determine the effect of individual care perception on the recovery quality of patients who underwent total knee arthroplasty in orthopedics and traumatology services. The research was carried out with 149 patients who underwent total knee arthroplasty in the orthopedics and traumatology services of Istanbul University Istanbul Medical Faculty Hospital between the dates 06.01.2021 and 09.10.2021. The data of the study were collected 'Patient Information Form', 'Individualized Care Scale-B', 'Quality of Recovery-40 Questionnaire (QoR-40)'. Statistical analyzes of the data obtained from the patients were performed in the SPSS (Statistical Packet for The Social Science) 25.0 package program. Descriptive tests in data analysis (minimum, maximum, mean, median, standard deviation, first quartile, third quartile, frequency and percentage), Shapiro-Wilk test, Independent groups t test, Mann-Whitney U, Kruskal Wallis Test, Dunn -Bonferroni, Pearson correlation analysis and logistic regression analysis were used. The mean age of the patients included in the study was 66,74±7,12, 73,2% were female, 71,1% were married, 38% were primary school graduates, and the average lenght of hospital stay was 5,73±1,65. It was observed that 49% of the patients in the study consisted of patients with a diagnosis of right gonarthrosis. It was determined that 51% of the patients did not have a chronic disease, 57,7% had a history of hospitalization before, 82,6% of them were administered local anesthesia, and 65,9% of the patients who were administered local anesthesia were administered spinal anesthesia. Individual care perception levels of the patients, mean total score were determined to be 4,60±0,37, sub-dimensions mean scores, respectively 'Clinical situation' was determined to be 4,72±0,40, 'Personal life situation' was determined to be 4,64±0,53, 'Decision control' was determined to be 4,43±0,36. The total mean score of the QoR-40 scale of the patients was determined to be 181,72±13,49, sub-dimensions mean scores 'Physical comfort' were determined to be as 53,62±4,89, 'Emotional situation' was determined to be as 41,44±3,22, 'Physical independence' was determined to be as 20,19±3,33, 'Patient support' was determined to be as 34,17±1,74 and 'Pain' was determined to be as 32,3±3,62. A statistically significant positive correlation was found in the correlation between the patients level of individual care perception and all sub-dimension mean scores, and the quality of recovery and all sub-dimension mean scores. It was determined that a one-point increase in the total score of the individual care perception caused an increase of 1.088 points in the total score of the quality of recovery. It was determined that the patients who underwent total knee arthroplasty had high levels of individual care perception and quality of recovery. It was determined that as the level of individual care perception increased, the level of quality of recovery increased as well. When the care is individualized and the most appropriate care is given to the individual, positive patient outcomes occur, and the quality of recovery and well-being of the patients are positively affected.
Description
Keywords
Hemşirelik, Diz eklemi, Diz protezi, Nursing, Fonksiyonel iyileşme, Knee joint, Knee prosthesis, Hasta bakımı, Recovery of function, Perioperatif hemşirelik, Patient care, Perioperative nursing, Yara iyileşmesi, Wound healing