Main Article Content
Hip arthroplasty rates are increasing since hip fractures are common in the growing elderly
population. The purpose of this research was to develop and study the effects of clinical nursing
practice guidelines for pain management in the elderly with hip arthroplasty. The sample consisted
of 30 elderly who had hip arthroplasty in Kalasin hospital in April-June 2019 and 15 nurses in the
Orthopedic Department. Data collection instruments were the clinical nursing practice guidelines
for pain management, pain management scale, and satisfaction with pain management. Data were
analyzed using descriptive statistics.
The results revealed that clinical nursing practice guidelines for pain management in the
elderly were implemented in four phases: pre-surgery, during surgery, post-operative, and pain
management aftercare. The majority of elderly (90%) had pain level reduced to a moderate level
within 72 hours after surgery. There was a high level of patient satisfaction with pain management
( = 27.21, x¯ SD = 1.07). All nurses used pharmacological management for pain. Long-term health
problems among community-dwelling elderly (80%) had moderate dependency. The effciency on
beneft of clinical nursing practice guidelines was highest level ( = 5.95, x¯ SD = 0.22). The results
suggest that these clinical nursing practice guidelines should be used from preoperative to
postoperative and aftercare phases in general and community hospitals with similar patients. Further
research should study cost effectiveness and days of hospitalization.
Menon, M. R., Majumdar, S. R., Wilson, D. M., Karkhaneh, M., Mousavi ,S. S., Wong, K.,
Tjosvold, L., & Jones, C. A. (2011). Comparative effectiveness of pain management
interventions for hip fracture: A systematic review. Annals of internal medicine, 155(4),
American Society of Anesthesiologists Task Force on Neuraxial Opioids, Horlocker, T. T.,
Burton, A. W., Connis, R. T., Hughes, S. C., Nickinovich, D. G., Palmer, C. M., Pollock, J. E.,
Rathmell, J. P., Rosenquist, R. W., Swisher, J. L., & Wu, C. L. (2009). Practice guidelines
for the prevention, detection, and management of respiratory depression associated
with neuraxial opioid administration. Anesthesiology, 111(2), 218-230.
Balen, R.V., Essink-Bot, M.L., Steyerberg, E.W., Cools, H.J., & Habbema, J.D. (2003). Quality of life after hip fracture: a comparison of four health status measures in 208 patients. Journal Disability and Rehabilitation. 25(10), 509-519.
Craig, J.V., Smyth, R.L. & Mullally, S. (2002). The evidence-based practice manual for
nurse. Edinburg: Cherchill Livingstone.
Gélinas, C., Arbour, C., Michaud, C., Vaillant, F., Desjardine, S. (2011). Implementation of the
critical-care pain observation tool on pain assessment/management nursing practices
in an intensive care unit with nonverbal critically ill adults : a before and after
study. Int J Nurs Stud, 48, 1495-504.
Gujol, M. C. (1994). A survey of pain assessment and management practices among critical
care nurses. American Journal of Critical Care, 3(2), 123-128.
Intaranongpai S., Khetphanya T., Thipsuphanphew T., Kam S., Senchai L., Chantakat A.,
Jumroonboon W., & Sornprang S. (2015). Chronic pain situational analysis and pain
management through community participation. Journal of Humanities and Social
Sciences, Mahasarakham University, 10(special), 412-421. [In Thai]
Jiarpinitnun J., (2014). The role of nurse anesthetists nurse in taking care of patients who
have been examined and treated for vascular disorders, nervous systems in
Ramathibodi Hospital. Ramathibodi Nursing Journal, 10(2), 92-100. [In Thai]
Jones, L. E. (2010). First steps: The early years of IASP 1973-1984. Seattle, Washington:
Khetpanya, T., & Suwannimitr, A. (2015). Outcome of care among pre surgery breast cancer
patients in fast track surgery. The 11th Mahasarakham university research conference
(pp. 486-491). Mahasarakham: Sarakhamprinting. [In Thai]
Klaewklong, S., Chanruangvanich, W., Danaidutsadeekul, S., & Riansuwan, K. (2014). Relation
of comorbidity, grip strength and stress to hip fracture patients’ post-operative
functional recovery. Thai journal of Nursing Council, 29(2), 36-48. [In Thai]
Kleinpell, R. M. (2017). Outcome assessment in advanced practice nursing (4th ed.).
New York, NY: Springer Publishing.
Lau, E. M. C. (2009). The epidemiology of osteoporosis in Asia. International Osteoporosis
Foundation, 6(11), 190-193.
Leelerdmongkolkul, W., Danaidutsadeekul, S., Chanruangvanich, W., & Udomkiat, P. (2013).
The relationship between body mass index, pain, social support and the activity
daily living during recovery phase in hip arthroplasty patients. Journal of Nursing
Scince, 31(2), 26-37. [In Thai]
Meelap, L., Saensom, D., & Methakanjanasak, N. (2017). Clinical nursing practice guideline
for acute pain management in critically ill patients. Srinagarind Medical Journal,
32(6). 561-570. [In Thai]
Melnyk, B.M. & Fineout-Overholt, E. (2005). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Lippincott William & Wilkins.
Ngamkham, S., Krutchan, N., Sawangchai, J., Wattanakul, B., Chidnayee, S., & Kiewcha-um, R.
(2018). Knowledge about Pain Assessment and Management of Thai Nurses. Journal
of Nursing and and Health Care, 36(1), 81-89. [In Thai]
Peeters, C. M., Visser, E., Van de Ree, C. L., Gosens, T., Den Oudsten, B. L., & De Vries, J.
(2016). Quality of life after hip fracture in the elderly: A systematic literature review.
International Journal of the Care of the Injury, 47(7), 1369-1382.
Pitantananukune, P. & Surit, P. (2011). Chronic pain management of older persons living in a
community. Journal of Nurses’ Association of Thailand, North-Eastern Division, 29(4),
58-68. [In Thai]
Seiger, C.P., & Wiese, B.S. (2009). Social support from work and family domains
as an antecedent or moderator of work-family conflict? Journal of Vocational
Behavior, 75(1), 26-37. DOI: 10.1016/j.jvb.2009.03.001
Soukup, S, M. (2000). The center for advanced nursing practice evidence-based practice
model: Promoting the scholarship of practice. Nursing Clinics of North America, 35(2),
Thai association for the study of pain (TASP). (2019). Clinical guidance for acute pain
Management. Retrieved January 9, 2019, from
http://www.anesthai.org/public/rcat/Documents/ [In Thai]
The National Guideline Clearinghouse. (2007). Retrieved January 19, 2019, from http://www.
The royal college of anesthesiologists of Thailand and Thai association for the study of pain.
(2012). Guideline for acute pain relief after pain surgery. Bangkok: Tanaplace,
Tiloksakulchai, F. (2006). Concepts and importance of evidence-based practice in the
implementation of empirical evidence: Principles and practices. (5th ed.).
Bangkok: Pee-one. [In Thai]
Yooyod, S. & Wongnaya, S. (2010). Development of practice guideline for postoperative pain
recovery room at Kamphaeng Phet hospital. The Golden Teak: Humanity and Social
Sciences Journal, 16(1), 156-167. [In Thai]