THE EFFECT OF TELE-NURSING PRACTİCE BASED ON OREM'S SELF-CARE THEORY ON THE SELF-CARE SKILL AND ACTIVITIES OF DAILY LIFE IN TRAUMA-RELATED LOWER EXTREMITY FRACTURE SURGERY PATIENTS: RANDOMIZED CONTROLLED EXPERIMENTAL STUDY PROTOCOL
Introduction: Traumatic injuries generally occur due to falls, vehicle accidents and violence, causing mortality, morbidity and disability. While tele-nursing monitoring prevents patients from being left alone in the problems they experience after discharge, the use of nursing models and theories can ensure that nurses play a guiding role, as well as protecting and improving health in these follow-ups. This study aims to determine the effect of tele-nursing application based on Orem's Self-Care Theory on self-care ability and daily living activities in trauma-related lower extremity fracture surgery patients.
Method: The research is planned to be conducted between September 2022 and January 2024. The research will be carried out prospectively with a randomized controlled experimental research design in the Orthopedics and Traumatology Clinics of a public university hospital and a city hospital in a province of Turkey. The sample of the study will include 52 patients, 26 of whom are intervention and 26 are control. Self-Care Skills Scale, KATZ Activities of Daily Living Scale (KGARS), Lawton Brody Activities of Daily Living Scale (LBGSAS) and an introductory information form to be created by the researchers in the light of the literature will be used to collect data.
Results: This study includes the protocol of a randomized controlled experimental study. Findings will be announced once the study data are collected and analyzed.
Conclusion: The effectiveness of tele-nursing application based on Orem's Self-Care Theory on self-care and activities of daily living will be evaluated after discharge in patients who underwent trauma-related lower extremity surgery.
1. Cogan CJ, Kandemir U. Role of peripheral nerve block in pain control for the management of acute traumatic orthopaedic injuries in the emergency department: Diagnosis-based treatment guidelines. In Injury. 2020; 51(7): 1422–1425. https://doi.org/10.1016/j.injury.2020.04.016
2. Parker M, Magnusson C. Assessment of trauma patients. International Journal of Orthopaedic and Trauma Nursing. 2016; 21: 21–30. https://doi.org/10.1016/j.ijotn.2015.10.002
3. Istituto Nazionale di Statistica. 2020. ISTAT. Road Accidents. Available at: https://www.istat.it/it/files//2021/07/Road-accidents_2020_EN.pdf Accessed on September 6, 2023.
4. Wu JC, Chen YC, Huang WC. Ossification of the posterior longitudinal ligament in cervical spine: Prevalence, management, and prognosis. In Neurospine. 2018; 15 (1): 33–41. https://doi.org/10.14245/ns.1836084.042
5. Emniyet Genel Müdürlüğü. Trafik İstatistik Bülteni. Trafik Kazası Istatistikleri 2021. http://trafik.gov.tr/kurumlar/trafik.gov.tr/04-Istatistik/Aylik/Ekim21.pdf Accessed on November 26, 2022.
6. SGK İstatistik Yıllıkları. Türkiye Cumhuriyeti Sosyal Güvenlik Kurumu. İş Kazası ve Meslek Hastalıkları İstatistikleri 2019. http://www.sgk.gov.tr/wps/portal/sgk/tr/kurumsal/istatistik/sgk_istatistik_yilliklari Accessed on November 26, 2022.
7. Bérubé M, Gélinas C, Martorella G, Feeley N, Côté J, Laflamme GY, Rouleau DM, Choinière M. Development and Acceptability Assessment of a Self-Management Intervention to Prevent Acute to Chronic Pain Transition after Major Lower Extremity Trauma. Pain Management Nursing. 2018; 19(6), 671–692. https://doi.org/10.1016/J.PMN.2018.04.010
8. Granström A, Strömmer L, Falk AC, Schandl A. Patient experiences of initial trauma care. International Emergency Nursing. 2019; 42: 25–29. https://doi.org/10.1016/J.IENJ.2018.08.003
9. Peters SE, Coppieters MW, Ross M, Johnston V. Health-care providers’ perspectives on factors influencing return-to-work after surgery for nontraumatic conditions of the upper extremity. Journal of Hand Therapy. 2020; 33(1), 87-95. https://doi.org/10.1016/J.JHT.2018.09.011
10. Troianello T, Yancosek K, Rhee PC. Unilateral hand training on functional performance in patients with upper extremity trauma. Journal of Hand Therapy. 2019; 32(1), 25-34. https://doi.org/10.1016/J.JHT.2017.10.002
11. Ekegren CL, Braaf S, Ameratunga S, Ponsford J, Nunn A, Cameron P, Lyons RA, Gabbe BJ. Adaptation, self-motivation and support services are key to physical activity participation three to five years after major trauma: a qualitative study. Journal of Physiotherapy. 2020; 66(3), 188–195. https://doi.org/10.1016/J.JPHYS.2020.06.008
12. van den Eeden YNT, de Turck BJG, van den Eeden FMC. 24 hours stay after hip replacement: Implementation of a patient-centered time-based fast-track program. Acta Orthopaedica. 2017; 88(1), 24–28. https://doi.org/10.1080/17453674.2016.1236229
13. International Council of Nurses (ICN). 2007. International Competencies for Telenursing. https://www.icn.ch/how-we-do-it/projects/ehealth-icnptm Accessed on November 26, 2022.
14. Carneiro França A, Bezerra Rodrigues A, Freire De Aguiar MI, Alves Silva R, Cartaxo Freitas FM, Alencar Melo GA. Telenursing for the control of chemotherapy-induced nausea and vomiting: A randomized clinical trial. Texto e Contexto Enfermagem, 2019; 28: 1-15. https://doi.org/10.1590/1980-265X-TCE-2018-0404
15. Dizavandi AR, Shakiba A, Rastaghi S, Rad M. Effect of Telenursing on the Self-efficacy of COVID-19 Patients after Discharge from Hospital. Evidence Based Care Journal. 2021; 11(3), 44–52. https://doi.org/10.22038/EBCJ.2021.59841.2551
16. Fallahpour S, Nasiri M, Fotokian Z, Alipoor Z, Hajiahmadi M. The effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis. Nursing and Midwifery Studies. 2020; 9(4), 201–207. https://doi.org/10.4103/nms.nms_111_19
17. Osorio-Calle YP, Sebastián-Aquino KJ, Meneses -La-Riva ME. Systematic Review: Tele-Nursing a Universal Access to Care for Oncology Patients. Jurnal Ners Dan Kebidanan (Journal of Ners and Midwifery). 2021; 8(3), 393–400. https://doi.org/10.26699/jnk.v8i3.art.p393-400
18. Sharma MM, Sanjay M, Aiims S, Himanshu JM, Aiims V, Nipin JM, Aiims K. Telenursing a boon for healthcare in India: A scoping Review. 2022. https://doi.org/10.21203/rs.3.rs-1543563/v1
19. Orem, D. E. Self-care deficit theory of nursing: concepts and applications (7 ed.). Dennis CM Mosby-Year Book Inc. 2001 p: 1-157. ISBN: 9780815124269
20. Karadağ A, Çalışkan N, Göçmen Baykara Z. Hemşirelik Teorileri ve Modelleri (A. Karadağ, N. Çalışkan, & Z. Göçmen Baykara, Eds.).
21. Masters K. (2011). Nursing Theories: A Framework for Professional Nursing Practice. Jones & Bartlett Learning.
22. Ma Y, Wu H, Wang Y, Guo L. Original Article A feasibility study of modified self-efficacy for the improvement of adverse emotions and quality of life in traumatic fracture patients. In Am J Transl Res. 2021; 13 (6): 6507–6515.
23. Biz C, Buffon L, Marin R, Petrova N. Orthopaedic nursing challenges in poly-traumatised patient management: A critical analysis of an Orthopaedic and Trauma Unit. International Journal of Orthopaedic and Trauma Nursing. 2016; 23, 60–71. https://doi.org/10.1016/j.ijotn.2016.04.003
24. Klunder-Rosser J, Pennington N. Does a specialised orthopaedic trauma module utilising high fidelity simulation improve student nurses’ perceptions of their competence? A pilot study. International Journal of Orthopaedic and Trauma Nursing. 2021; 41: 100800. https://doi.org/10.1016/j.ijotn.2020.100800
25. Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013; 346: e7586.
26. Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 340: c869–9.
27. Akay B, Durmaz Akyol A. Kronik Kalp Yetersizliği Olan Hastalarda Tele İzlem Yönteminin Özbakım Gücüne Olan Etkisinin İncelenmesi /Investigation Of The Effect Of Tele Monitoring On The Self Care Agency In Patients With Chronic Heart Failure. Türk Kardiyol Dern Kardiyovasküler Hemşirelik Dergisi - Turk Soc Cardiol Turkish Journal of Cardiovascular Nursing. 2014; 5(2), 75–88. https://doi.org/10.5543/khd.2014.009
28. Meşe S, Güler S, Korkmaz M. Diz Artroplastisi Hastalarına Yönelik Geliştirilen Mobilizasyon Protokolünün Hemşirelik Bakımına Duyarlı Hasta Sonuçları Üzerine Etkisi: Çok Merkezli, Tek Kör Randomize Kontrollü Bir Çalışma Protokolü. Gazi Sağlık Bilimleri Dergisi. 2023; 8(1), 79-95.
29. Kearney BY, Fleischer BJ. Development of an Instrument to Measure Exercise of Self-care Agency. Research in Nursing and Health, 1979; 2(I), 25–34.
30. Nahcivan NO. A Turkish language equivalence of the exercise of self-care agency scale. Western Journal of Nursing Research, 2004; 26(7), 813–824. https://doi.org/10.1177/0193945904267599
31. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in The Aged. The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. JAMA. 1963; 185, 914–919.
32. Arik G, Varan HD, Yavuz BB, Karabulut E, Kara O, Kilic MK, Kizilarslanoglu MC, Sumer F, Kuyumcu ME, Yesil Y, Halil M, Cankurtaran M. Validation of Katz index of independence in activities of daily living in Turkish older adults. Archives of Gerontology and Geriatrics. 2015; 61(3), 344–350. https://doi.org/10.1016/J.ARCHGER.2015.08.019
33. Lawton MP, Brody EM. Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. The Gerontologist. 1969; 9(3), 179–186.
34. Güzel A, Üner S, Turan S, Uçan Yamaç S. Lawton ve Brody Enstrümental Günlük Yaşam Aktiviteleri Ölçeği Türkçe Geçerlik ve Güvenirliği. 3.International 21.National Public Health Congress. 2019.
35. Akarsu K, Güler S. Travma Nedeniyle Alt Ekstremite Fraktür Cerrahisi Geçiren Hastaların Deneyimleri: Fenomenolojik Bir Araştırma. 5. Uluslararası 13. Ulusal Türk Cerrahı̇ Ve Amelı̇yathane Hemşı̇relerı̇ Kongresı̇. 2023.
36. Akarsu K, Güler S, Bulut H. Ortopedı̇ Ve Travmatolojı̇ Hemşı̇relerı̇nı̇n Travma Nedenı̇yle Ekstremı̇te Cerrahı̇sı̇ Geçı̇ren Hastalarla İlgı̇lı̇ Deneyı̇mlerı̇. 4. Uluslararası 12. Ulusal Türk Cerrahı̇ Ve Amelı̇yathane Hemşı̇relı̇ğı̇ Kongresı̇. 2022.
Giriş: Travmatik yaralanmalar genellikle düşme, taşıt kazası ve şiddet kaynaklı gerçekleşerek mortalite, morbidite ve engelliliğe neden olmaktadır. Tele-hemşirelik izlemi ile hastaların taburculuk sonrası yaşadıkları sorunlarda yalnız kalmaları önlenirken, hemşirelik teorilerinin ve modellerinin kullanılması ile bu izlemlerde sağlığın korunması ve geliştirilmesinin yanı sıra, hemşirelere yol gösterici rol oynaması da sağlanabilmektedir. Bu çalışmada, travmaya bağlı alt ekstremite fraktür cerrahisi hastalarında Orem’in Öz Bakım Teorisine temellendirilmiş tele-hemşirelik uygulamasının öz bakım gücü ve günlük yaşam aktivitelerine etkisini belirlemek amaçlanmaktadır.
Yöntem: Araştırmanın, Eylül 2022-Ocak 2024 tarihleri arasında yapılması planlanmaktadır. Araştırma, Türkiye’nin bir ilindeki kamu üniversitesi hastanesi ve şehir hastanesine bağlı Ortopedi ve Travmatoloji Kliniklerinde, randomize kontrollü deneysel araştırma tasarımı ile prospektif olarak gerçekleştirilecektir. Araştırmanın örneklemine, 26’sı müdahale, 26’sı kontrol üzere 52 hasta alınacaktır. Verilerin toplanmasında Özbakım Gücü Ölçeği, KATZ günlük yaşam aktiviteleri ölçeği (KGYAÖ), Lawton Brody Günlük Yaşam Aktiviteleri Ölçeği (LBGYAÖ) ve araştırmacılar tarafından literatür ışığında oluşturulacak tanıtıcı bilgi formu kullanılacaktır.
Bulgular: Bu çalışma, randomize kontrollü deneysel çalışmanın protokolünü içermektedir. Çalışma verileri toplanıp analiz edildikten sonra bulgular açıklanacaktır.
Sonuç: Travmaya bağlı alt ekstremite ameliyatı yapılan hastalarda taburculuk sonrası Orem’in Öz Bakım Teorisine temellendirilmiş tele-hemşirelik uygulamasının öz bakım ve günlük yaşam aktiviteleri üzerine etkinliği değerlendirilecektir.
1. Cogan CJ, Kandemir U. Role of peripheral nerve block in pain control for the management of acute traumatic orthopaedic injuries in the emergency department: Diagnosis-based treatment guidelines. In Injury. 2020; 51(7): 1422–1425. https://doi.org/10.1016/j.injury.2020.04.016
2. Parker M, Magnusson C. Assessment of trauma patients. International Journal of Orthopaedic and Trauma Nursing. 2016; 21: 21–30. https://doi.org/10.1016/j.ijotn.2015.10.002
3. Istituto Nazionale di Statistica. 2020. ISTAT. Road Accidents. Available at: https://www.istat.it/it/files//2021/07/Road-accidents_2020_EN.pdf Accessed on September 6, 2023.
4. Wu JC, Chen YC, Huang WC. Ossification of the posterior longitudinal ligament in cervical spine: Prevalence, management, and prognosis. In Neurospine. 2018; 15 (1): 33–41. https://doi.org/10.14245/ns.1836084.042
5. Emniyet Genel Müdürlüğü. Trafik İstatistik Bülteni. Trafik Kazası Istatistikleri 2021. http://trafik.gov.tr/kurumlar/trafik.gov.tr/04-Istatistik/Aylik/Ekim21.pdf Accessed on November 26, 2022.
6. SGK İstatistik Yıllıkları. Türkiye Cumhuriyeti Sosyal Güvenlik Kurumu. İş Kazası ve Meslek Hastalıkları İstatistikleri 2019. http://www.sgk.gov.tr/wps/portal/sgk/tr/kurumsal/istatistik/sgk_istatistik_yilliklari Accessed on November 26, 2022.
7. Bérubé M, Gélinas C, Martorella G, Feeley N, Côté J, Laflamme GY, Rouleau DM, Choinière M. Development and Acceptability Assessment of a Self-Management Intervention to Prevent Acute to Chronic Pain Transition after Major Lower Extremity Trauma. Pain Management Nursing. 2018; 19(6), 671–692. https://doi.org/10.1016/J.PMN.2018.04.010
8. Granström A, Strömmer L, Falk AC, Schandl A. Patient experiences of initial trauma care. International Emergency Nursing. 2019; 42: 25–29. https://doi.org/10.1016/J.IENJ.2018.08.003
9. Peters SE, Coppieters MW, Ross M, Johnston V. Health-care providers’ perspectives on factors influencing return-to-work after surgery for nontraumatic conditions of the upper extremity. Journal of Hand Therapy. 2020; 33(1), 87-95. https://doi.org/10.1016/J.JHT.2018.09.011
10. Troianello T, Yancosek K, Rhee PC. Unilateral hand training on functional performance in patients with upper extremity trauma. Journal of Hand Therapy. 2019; 32(1), 25-34. https://doi.org/10.1016/J.JHT.2017.10.002
11. Ekegren CL, Braaf S, Ameratunga S, Ponsford J, Nunn A, Cameron P, Lyons RA, Gabbe BJ. Adaptation, self-motivation and support services are key to physical activity participation three to five years after major trauma: a qualitative study. Journal of Physiotherapy. 2020; 66(3), 188–195. https://doi.org/10.1016/J.JPHYS.2020.06.008
12. van den Eeden YNT, de Turck BJG, van den Eeden FMC. 24 hours stay after hip replacement: Implementation of a patient-centered time-based fast-track program. Acta Orthopaedica. 2017; 88(1), 24–28. https://doi.org/10.1080/17453674.2016.1236229
13. International Council of Nurses (ICN). 2007. International Competencies for Telenursing. https://www.icn.ch/how-we-do-it/projects/ehealth-icnptm Accessed on November 26, 2022.
14. Carneiro França A, Bezerra Rodrigues A, Freire De Aguiar MI, Alves Silva R, Cartaxo Freitas FM, Alencar Melo GA. Telenursing for the control of chemotherapy-induced nausea and vomiting: A randomized clinical trial. Texto e Contexto Enfermagem, 2019; 28: 1-15. https://doi.org/10.1590/1980-265X-TCE-2018-0404
15. Dizavandi AR, Shakiba A, Rastaghi S, Rad M. Effect of Telenursing on the Self-efficacy of COVID-19 Patients after Discharge from Hospital. Evidence Based Care Journal. 2021; 11(3), 44–52. https://doi.org/10.22038/EBCJ.2021.59841.2551
16. Fallahpour S, Nasiri M, Fotokian Z, Alipoor Z, Hajiahmadi M. The effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis. Nursing and Midwifery Studies. 2020; 9(4), 201–207. https://doi.org/10.4103/nms.nms_111_19
17. Osorio-Calle YP, Sebastián-Aquino KJ, Meneses -La-Riva ME. Systematic Review: Tele-Nursing a Universal Access to Care for Oncology Patients. Jurnal Ners Dan Kebidanan (Journal of Ners and Midwifery). 2021; 8(3), 393–400. https://doi.org/10.26699/jnk.v8i3.art.p393-400
18. Sharma MM, Sanjay M, Aiims S, Himanshu JM, Aiims V, Nipin JM, Aiims K. Telenursing a boon for healthcare in India: A scoping Review. 2022. https://doi.org/10.21203/rs.3.rs-1543563/v1
19. Orem, D. E. Self-care deficit theory of nursing: concepts and applications (7 ed.). Dennis CM Mosby-Year Book Inc. 2001 p: 1-157. ISBN: 9780815124269
20. Karadağ A, Çalışkan N, Göçmen Baykara Z. Hemşirelik Teorileri ve Modelleri (A. Karadağ, N. Çalışkan, & Z. Göçmen Baykara, Eds.).
21. Masters K. (2011). Nursing Theories: A Framework for Professional Nursing Practice. Jones & Bartlett Learning.
22. Ma Y, Wu H, Wang Y, Guo L. Original Article A feasibility study of modified self-efficacy for the improvement of adverse emotions and quality of life in traumatic fracture patients. In Am J Transl Res. 2021; 13 (6): 6507–6515.
23. Biz C, Buffon L, Marin R, Petrova N. Orthopaedic nursing challenges in poly-traumatised patient management: A critical analysis of an Orthopaedic and Trauma Unit. International Journal of Orthopaedic and Trauma Nursing. 2016; 23, 60–71. https://doi.org/10.1016/j.ijotn.2016.04.003
24. Klunder-Rosser J, Pennington N. Does a specialised orthopaedic trauma module utilising high fidelity simulation improve student nurses’ perceptions of their competence? A pilot study. International Journal of Orthopaedic and Trauma Nursing. 2021; 41: 100800. https://doi.org/10.1016/j.ijotn.2020.100800
25. Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013; 346: e7586.
26. Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 340: c869–9.
27. Akay B, Durmaz Akyol A. Kronik Kalp Yetersizliği Olan Hastalarda Tele İzlem Yönteminin Özbakım Gücüne Olan Etkisinin İncelenmesi /Investigation Of The Effect Of Tele Monitoring On The Self Care Agency In Patients With Chronic Heart Failure. Türk Kardiyol Dern Kardiyovasküler Hemşirelik Dergisi - Turk Soc Cardiol Turkish Journal of Cardiovascular Nursing. 2014; 5(2), 75–88. https://doi.org/10.5543/khd.2014.009
28. Meşe S, Güler S, Korkmaz M. Diz Artroplastisi Hastalarına Yönelik Geliştirilen Mobilizasyon Protokolünün Hemşirelik Bakımına Duyarlı Hasta Sonuçları Üzerine Etkisi: Çok Merkezli, Tek Kör Randomize Kontrollü Bir Çalışma Protokolü. Gazi Sağlık Bilimleri Dergisi. 2023; 8(1), 79-95.
29. Kearney BY, Fleischer BJ. Development of an Instrument to Measure Exercise of Self-care Agency. Research in Nursing and Health, 1979; 2(I), 25–34.
30. Nahcivan NO. A Turkish language equivalence of the exercise of self-care agency scale. Western Journal of Nursing Research, 2004; 26(7), 813–824. https://doi.org/10.1177/0193945904267599
31. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in The Aged. The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. JAMA. 1963; 185, 914–919.
32. Arik G, Varan HD, Yavuz BB, Karabulut E, Kara O, Kilic MK, Kizilarslanoglu MC, Sumer F, Kuyumcu ME, Yesil Y, Halil M, Cankurtaran M. Validation of Katz index of independence in activities of daily living in Turkish older adults. Archives of Gerontology and Geriatrics. 2015; 61(3), 344–350. https://doi.org/10.1016/J.ARCHGER.2015.08.019
33. Lawton MP, Brody EM. Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. The Gerontologist. 1969; 9(3), 179–186.
34. Güzel A, Üner S, Turan S, Uçan Yamaç S. Lawton ve Brody Enstrümental Günlük Yaşam Aktiviteleri Ölçeği Türkçe Geçerlik ve Güvenirliği. 3.International 21.National Public Health Congress. 2019.
35. Akarsu K, Güler S. Travma Nedeniyle Alt Ekstremite Fraktür Cerrahisi Geçiren Hastaların Deneyimleri: Fenomenolojik Bir Araştırma. 5. Uluslararası 13. Ulusal Türk Cerrahı̇ Ve Amelı̇yathane Hemşı̇relerı̇ Kongresı̇. 2023.
36. Akarsu K, Güler S, Bulut H. Ortopedı̇ Ve Travmatolojı̇ Hemşı̇relerı̇nı̇n Travma Nedenı̇yle Ekstremı̇te Cerrahı̇sı̇ Geçı̇ren Hastalarla İlgı̇lı̇ Deneyı̇mlerı̇. 4. Uluslararası 12. Ulusal Türk Cerrahı̇ Ve Amelı̇yathane Hemşı̇relı̇ğı̇ Kongresı̇. 2022.