Factors Influencing Postoperative Functional Ability of People with Simple Lower Extremity Fractures

Authors

  • Yin Mar Han PhD Candidate, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand. University of Nursing, Mandalay, Myanmar.
  • Suparb Aree-ue PhD, Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Pisamai Orathai PhD, Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Paphon Sa- ngasoongsong MD, Associate Professor, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.

Keywords:

Discharge teaching, Functional ability, Hospital setting, Lower extremity fracture, Myanmar, Pain

Abstract

                  Early restoration of functional ability of people with lower extremity fracture is essential for a speedy return to life activities, including work. Simple lower extremity fractures of working-age adults are surgically treated to regain postoperative functional ability as early as possible. Even with successful orthopedic surgery, postoperative functional improvement varies widely due to many factors. This predictive correlational study examined the predictability of educational status, psychological distress, hospital setting, quality of discharge teaching, pain with activity, and satisfaction with care on functional ability at postoperative six-week in working-age adults with simple lower extremity fractures. In three orthopedic care settings in Myanmar, 178 participants completed the Patient Data Record Form, Impact of Event Scale-Revised, Quality of Discharge Teaching Scale, Numeric Rating Scale-Pain, Patient Satisfaction with Nursing Care Quality Questionnaire, and Lower Extremity Measure. Data were analyzed by using descriptive statistics, Spearman’s rank correlation coefficient and hierarchical regression analysis.

                Results showed that psychological distress, hospital setting, quality of discharge teaching, and pain with activity were significant predictors of postoperative functional ability of people with lower extremity fractures. The significant predictors jointly explained 39.4% of the variance in postoperative functional ability. However, educational status and satisfaction with care were insignificant predictors. These findings may help nurses and other health professionals to develop programs for psychological intervention, discharge teaching, and postoperative pain control in line with the characteristics of various hospital settings. These may improve quality of nursing care and enhance clinical outcomes that help people with simple lower extremity fractures to regain independent lower extremity function and resume work as early as possible.

References

1. Haagsma JA, Graetz N, Bolliger I, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Injury Prevention. 2016; 22(1): 3-18.

2. Ministry of Health and Sport. Public Health Statistics Report 2014-2016. Nay Pyi Taw: Department of Public Health. 2017. 93p.

3. Department of Public Health & Department of Medical Services. Annual hospital statistics report 2013. Ministry of Health, Myanmar. Nay Pyi Taw.2015.175p.

4. Sluys KP, Shults J, Richmond TS. Health related quality of life and return to work after minor extremity injuries: a longitudinal study comparing upper versus lower extremity injuries. Injury. 2016; 47(4): 824-831.

5. Kellezi B, Coupland C, Morriss R, et al. The impact of psychological factors on recovery from injury: a multicentre cohort study. Soc Psychiatry Psychiatr Epidemiol. 2017; 52(7):855-66.

6. O’Hara NN, Mugarura R, Potter J, et al. Economic loss due to traumatic injury in Uganda: the patient's perspective. Injury. 2016; 47(5):1098-1103.

7. Clelland SJ, Chauhan P, Mandari FN. The epidemiology and management of tibia and fibula fractures at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. Pan Afr Med J. 2016; 25: 51. doi: 10.11604/pamj.2016. 25.51.10612.

8. Associates in Physical Medicine and Rehabilitation. (n.d.). Rehabilitation helps stroke patients recover skills. Retrieved 22 September 2017, from https://www.apmandr.com/resources/ rehabilitation-helps-stroke-patients-recover-skills-2/

9. Ayers DC, Franklin PD, Ring DC. The role of emotional health in functional outcomes after orthopedic surgery: extending the biopsychosocial model to orthopaedics: AOA critical issues. J Bone Joint Surg Am. 2013; 95(21). doi: 10.2106/JBJS.L.00799.

10. Feldman CH, Dong Y, Katz JN, Donnell-Fink LA, Losina E. Association between socioeconomic status and pain, function and pain catastrophizing at presentation for total knee arthroplasty. BMC Musculoskelet Disord. 2015; 16:18. doi: 10.1186/s12891-015-0475-8.

11. American Academy of Orthopedic Surgeons. Position statement. Specialty Hospital [Internet]. Aaos.org. 2016 [cited 11 November 2018]. Available from: https:// www.aaos.org/uploadedFiles/ PreProduction/About/ Opinion_Statements/position/1167SpecialtyHospitals.pdf

12. Mayich DJ, Tieszer C, Lawendy A, McCormick W, Sanders D. Role of patient information handouts following operative treatment of ankle fractures: a prospective randomized study. Foot Ankle Int. 2013; 34(1): 2-7. doi: 10. 1177/1071100712460229.

13. Hida M, Deguchi Y, Miyaguchi K, et al. Association between acute postoperative pain and recovery of independent walking ability after surgical treatment of hip fracture. Progress in Rehabilitation Medicine. 2018;(3):1- 7. doi: https://doi.org/10.2490/prm.20180012.

14. Baumann C, Rat AC, Mainard D, Cuny C, Guillemin F. Importance of patient satisfaction with care in predicting osteoarthritis-specific health-related quality of life one year after total joint arthroplasty. Qual Life Res. 2011; 20(10):1581-8. doi: 10.1007/s11136-011-9913-8.

15. Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966; 44(3):166-206.

16. Donabedian A. The quality of care: how can it be assessed?. JAMA. 1988; 260(12):1743-1748.

17. Moore L, Lavoie A, Bourgeois G, Lapointe J. Donabedian's structure-process-outcome quality of care model: validation in an integrated trauma system. J Trauma Acute Care Surg. 2015;78(6):1168-1175. doi: 10.1097/TA.0000 000000000663.

18. Aree-Ue S, Roopsawang I, Kawinwonggowit V. Factors predicting functional ability among older adults undergoing hip and knee arthroplasty. Pacific Rim Int J of Nurs Res. 2019; 23(2):156-159.

19. Bosse G, Mtatifikolo F, Abels W, Strosing C, Breuer JP, Spies C. Immediate outcome indicators in perioperative care: a controlled intervention study on quality improvement in hospitals in Tanzania. PloS One. 2013;8(6):e65428. doi:10.1371/journal.pone.0065428.

20. Zimmerman EB, Woolf SH, Haley A. Understanding the relationship between education and health. In RM Kaplan, ML Spittel, DH David, editors. Population health: behavioral and social science insights. Rockville: the Agency for Healthcare Research and Quality Publication; 2015. p 347-384.

21. Vincent HK, Horodyski M, Vincent KR, Brisbane ST, Sadasivan KK. Psychological distress after orthopedic trauma: prevalence in patients and implications for rehabilitation. PM&R. 2015;7(9):978-89. doi: 10.1016/j.pmrj.2015. 03.007.

22. Goebel S, Steinert A, Vierheilig C, Faller H. Correlation between depressive symptoms and perioperative pain: a prospective cohort study of patients undergoing orthopedic surgeries. Clin J Pain. 2013;29(5):392-399. doi: 10.1097/AJP.0b013e318262e2c8.

23. Abtahi AM, Brodke DS, Lawrence BD, Zhang C, Spiker WR. Association between patient-reported measures of psychological distress and patient satisfaction scores in a spine surgery patient population. J Bone Joint Surg Am. 2015;97(10):824-828. doi: 10.2106/JBJS.N.00916.

24. McFarland DC, Shen MJ, Parker P, Meyerson S, Holcombe RF. Does hospital size affect patient satisfaction? Qual Manag Health Care. 2017;26(4):205-209. doi: 10.1097/QMH.0000000000000149.

25. Eastaugh SR. Hospital specialization: benefits-focused product line planning. J Health Care Finance. 2015; 41(3).1-15.

26. American Nurses Association. Optimal nurse staffing to improve quality of care and patient outcomes: Executive summary. [place unknown]: Avalere Health LLC; 2015. 45p.

27. Murdock A, Griffin B. How is patient education linked to patient satisfaction? Nursing2018. 2013;43(6):43-45. doi: 10.1097/01.NURSE.0000427101.75399.fe.

28. Charalambous A, Papastavrou E, Valkeapää K, et al. content of orthopedic patient education provided by nurses in seven european countries. CNR. 2017; 27(7):770-789. doi: 10.1177/1054773817713178.

29. Barbosa MH, Araújo NF, Silva JA, Corrêa TB, Moreira TM, Andrade ÉV. Pain assessment intensity and pain relief in patients post-operative orthopedic surgery. Escola Anna Nery. 2014;18(1):143-147. doi: 10.1177/105477 3817713178.

30. WHO. Process of translation and adaptation of instruments. nd; https://www.who.int/substance_abuse/research_ tools/translation/en/. Accessed 7 March, 2017.

31. Weiss DS, Marmar CR. The Impact of Event ScaleRevised. In JP Wilson & TM Keane (Eds.), Assessing psychological trauma and PTSD. New York: The Guilford Press. 1997. p. 399-411.

32. Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale-revised. Behav Res Ther. 2003; 41(12):1489-96.

33. Weiss ME, Piacentine LB, Lokken L, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurs Spec. 2007;21(1):31-42.

34. Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH. Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990;17(8):1022-1024.

35. Laschinger HS, Hall LM, Pedersen C, Almost J. A psychometric analysis of the patient satisfaction with nursing care quality questionnaire: an actionable approach to measuring patient satisfaction. J Nurs Care Qual. 2005;20(3):220-30.

36. Jaglal S, Lakhani Z, Schatzker J. Reliability, validity, and responsiveness of the lower extremity measure for patients with a hip fracture. J Bone Joint Surg Am. 2000;82(7): 955-62.

37. Ryf CR, Arraf J. Postoperative fracture treatment: general considerations. In TP Ruedi, RE Buckley, CG Moran, editors. AO principles of fracture management. 2nd ed. Davos: AO Publishing; 2007.447p.

38. Singh JA, Ramachandran R. Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US? Arthritis Care & Res. 2015;67(6):885-90. doi: 10.1002/acr.22507.

39. Plummer V, Copnell B. Collaboration between nurses and physicians in an Indonesian Emergency Department. Australas Emerg Nurs J. 2016;19(2):82-9. doi: 10. 1016/j.aenj.2016.04.001.

40. Szeverenyi C, Kekecs Z, Johnson A, Elkins G, Csernatony Z, Varga K. The use of adjunct psychosocial interventions can decrease postoperative pain and improve the quality of clinical care in orthopedic surgery. A systematic review and meta-analysis of randomized controlled trials. J Pain. 2018; 19 (11):1231-1252. doi: 10.1002/msc.1142.

Downloads

Published

2019-09-16

How to Cite

1.
Han YM, Aree-ue S, Orathai P, Sa- ngasoongsong P. Factors Influencing Postoperative Functional Ability of People with Simple Lower Extremity Fractures. PRIJNR [Internet]. 2019 Sep. 16 [cited 2024 Nov. 22];23(4):368-83. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/170279

Issue

Vol. 23 No. 4 (2019): October-December 2019

Section

Original paper

License

Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.