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Problems Experienced by Patients in the Clinic and at Home after Orthopedic Surgery and Their Level of Care Dependency

Yıl 2025, Cilt: 18 Sayı: 1, 56 - 72
https://doi.org/10.46483/jnef.1406445

Öz

Background: The care needs of patients who underwent orthopedic surgery are not limited to the hospital but continue at home after discharge.
Objectives: The aim of this study is to determine the problems and care dependency levels of patients who has orthopedic surgery in the clinic after the surgery and at home in the first month of discharge.
Methods: Between March 1, 2021 and April 18, 2022, 113 patients (aged 18 and over), who were hospitalized in the orthopedics and traumatology clinic of public hospital due to orthopedic surgery, were included in study. Data were collected using the “Patient Information Form (Part I), Follow-up Form (Part II),” and “Care Dependency Scale.” Data were evaluated using mean, standard deviation, median, minimum-maximum, number and percentage, McNemar, McNemarBrowker, eta squared (η2), Cohen’s d, Kruskal Wallis-H test, Dunn’s test for multiple comparisons and Linear regression analysis.
Results: It has determined that patients who had orthopedic surgery mostly had difficulties in fulfill their self care needs and physical mobility limitations. With the relief of patients’ pain and anxiety, an increase in their belief in recovery and a decrease in their dependency levels were observed. In the linear regression model, only 17% of the changes in care dependency could be explained by independent variables, but the independent variables were not statistically significant.
Conclusion: Orthopedic patients experience high levels of mobility limitation and care dependency. There was a decrease in care dependency in the first month after discharge compared to the third day in the clinic.

Kaynakça

  • Acar, E. Z, & Fındık, Ü. Y. (2021). The problems of the patients that after surgery living at home and post-surgery patient’s problems at home on illness perception. Journal of Ege University Nursing Faculty (JEUNF), 37(3), 197-206. https://doi.org/10.53490/egehemsire.943140.
  • Akbari, A., Nasiri, A., & Amirabadizade, A. (2018). Effects of discharge education and telephone follow-up on pa-tient satisfaction and readmission after orthopedic surgery. Journal of Surgery and Trauma, 6(4), 122-127.
  • Akyüz, E., Ünlü, H., Uğurlu, Z., & Özhan Elbaş, N. H. (2021). Psychosocial problems and changes in quality of life experienced by patients who underwent orthopedic surgery. Health and Society, 31(3), 79-93.
  • Aydın, N., & Yılmaz, D. Ü. (2022). Investigation of nursing diagnosis of orthopedic patients by clinical practice students. Gümüşhane University Journal of Health Sciences, 11(1), 257-263.
  • Baksi, A., & Genç, H. (2020). Examination of care dependency of patients undergoing surgical intervention in terms of perception of care, sociodemographic and clinical characteristics. Turkiye Klinikleri Journal of Nursing Sci-ences, 12(4), 465-72. https://doi.org/10.5336/nurses.2020-75291.
  • Bektaşoğlu, B., & Eyi, S. (2021). Care according to kolcaba’s comfort theory in individuals undergoing lower ex-tremity surgery. Journal of Nursing Science, 4(3), 148-155. https://doi.org/10.54189/hbd.875287.
  • Bilik, Ö. (2017). Travel to home from the clinic: home care of the surgery patients. Journal of Ege University Nurs-ing Faculty (JEUNF), 3381), 114-127.
  • Ciğerci, Y., Özdemir, H., & Kılıç, İ. (2016). The patient safety culture perception of surgery nurses and its relation-ship with sociodemographic characteristics. Journal of Duzce University Health Sciences Institute, 6(3), 149-153.
  • Dinçer, A., & Kurşun, Ş. (2019). Determining the problems experienced by the elderly at home after (following) surgical interventions. Acıbadem University Health Sciences Journal, 10(3), 518-523. https://doi.org/10.31067/0.2019.184.
  • Doroszkiewicz, H., Sierakowska, M., & Muszalik, M. (2018). Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients. Clinical Interventions in Aging, 8(13), 887–894. https://doi.org/10.2147/CIA.S159511
  • Durgun, H., Duman, S., & Şahin, K. (2022). Investigation of dependence levels and perceptions of nursing care of inpatients in surgical and medical services. Journal of Nursology, 25(1), 31-35. https://doi.org/10.54614/JANHS.2022.688251.
  • Gosens, T., & den Oudsten, B. L. (2023). Psychology in orthopedics and traumatology: an instructional review. EFORT open reviews, 8(5), 245–252. https://doi.org/10.1530/EOR-23-0038
  • Gürler, H. (2021). Care requirements of patients undergoing surgery intervention due to the femur fracture accord-ing to functional health patterns model. Journal of Education and Research in Nursing, 18(4), 415-422. https://doi.org/10.5152/jern.2021.05925
  • Yönt, GH., A. Korhan, E., Khorshid, L., Eşer, İ., & Dijkstra, A. (2010). Examining the validity and reliability of the care dependency scale in elderly individuals. Turkish Journal of Geriatrics, Special Issue, (13), 71.
  • Hauer, G., Sadoghi, P., Smolle, M., Zaussinger, S., Friesenbichler, J., Leithner, A., & Maurer-Ertl, W. (2023). Sex-ual activity after short-stem total hip arthroplasty. Does stem size matter? Archives of Orthopaedic and Trauma Surgery, 143(6), 3613–3619. https://doi.org/10.1007/s00402-022-04614-y
  • Hijji, F. Y., Cheslik, T. G., Schneider, A. D., Schach, B. M., & Venkatarayappa, I. (2021). The popularity of out-come measures used in shoulder arthroplasty literature. Shoulder & Elbow, 13(3), 237–247. https://doi.org/10.1177/1758573220935865
  • Imeni, M., Sabouhi, F., Abazari, P., & Iraj, B. (2018). The effect of spiritual care on the body image of patients un-dergoing amputation due to Type 2 Diabetes: A randomized clinical trial. Iranian Journal of Nursing and Midwifery Research, 23(4), 322–326. https://doi.org/10.4103/ijnmr.IJNMR_113_15
  • Kalantar, S., Farhoud, A., & Mortazavi, J. (2020). Lockdown of an orthopedic department during COVID-19 epi-demics, our experience in a general hospital. The Archives of Bone and Joint Surgery, 8(Suppl1), 235–241. https://doi.org/10.22038/abjs.2020.47834.2362
  • Karakoç, Y., & Atalay, İ. B. (2019). The role of magnetic resonance imaging and clinical assessments in predicting meniscal tear surgery. Joint Diseases and Related Surgery, 30(2), 85-90. https://doi.org/10.5606/ehc.2019.66962
  • Kılıç, H. F., Cevheroğlu, S., & Görgülü, S. (2017). Determination of care dependency level of patients staying in medical and surgical clinics. E-Journal of Dokuz Eylul University Nursing Faculty, 10(1), 22-28.
  • Koç, S., Büker, N., Şavkın, R., & Kıter, E. (2012). The effects of independence and depression level on patients’ satisfaction with nursing care in orthopedics and traumatology patients. The Journal of Kartal Training and Re-search Hospital, 23(3), 130-136. https://doi.org/10.5505/jkartaltr.2012.49092
  • Kubat Bakır, G., & Yurt, S. (2020). Evaluation of the comfort level of the post-surgical patients. Health and Socie-ty, 20(3), 158-165.
  • Martin, C., Parellada, C., Vez, H., Urgiles, C., Piedra, J., & Guix, J. (2022). Telemedicine Approach for Patient Fol-low-up After Total Knee and Reverse Total Shoulder Arthoplasty: A pilot Study. International Journal of Computer Assisted Radiology and Surgery, 18(3), 598-602.
  • Neonakis, E. M., Perna, F., Traina, F., Faldini, O., Antoniou, G., Kyriakopoulos, G., Triantafyllopoulos, I. K., Megaloikonomos, P. D., & Faldini, C. (2020). Total hip arthroplasty and sexual activity: a systematic review. Mus-culoskeletal Surgery, 104(1), 17–24. https://doi.org/10.1007/s12306-020-00645-z
  • Ozveren, H., Faydali, S., Sasmaz, S., F. Dokuz, H., & Gulnar, E. (2021). Care dependency and quality of life in old-er adult patients. International Journal of Caring Sciences, 14(1), 319-325.
  • Rocha, P., Baixinho, C. L., Marques, A., & Henriques, A. (2022). Safety-Promoting interventions for the older per-son with hip fracture on returning home: A protocol for a systematic review. Journal of Personalized Medicine, 12(5), 654. https://doi.org/10.3390/jpm12050654
  • Rougereau, G., Rabot, C., de Thomasson, E., Tourabaly, I., Mazel, C., Langlais, T., & Ollat, D. (2022). Sexual ac-tivity resumption after total hip arthroplasty: A satisfaction survey in 101 patients. Orthopaedics & Traumatology, Surgery & Research: OTSR, 108(1), 103171. https://doi.org/10.1016/j.otsr.2021.103171
  • Silva, M. B., Palma, M., Engelman, B., Figueiredo, M. S., & Abreu Almeida, M. (2021). Positioning of orthopedic patients according to the nursing outcomes classidic ation. J Nurs. UFPE On Line, 15(2), https://doi.org/10.5205 / 1981-8963.2021.245744
  • T. Damar, H., & Bilik, Ö. (2018). Pain intensity and the affecting factors in elderly patients with arthroplasty sur-gery. Journal of Geriatric Science, 1(3), 104-112.
  • Turan, N., & Sendir, M. (2019). Defining care needs for inpatients in the orthopaedics and traumatology clinic. In-ternational Journal of Caring Sciences, 12(2), 1001-1007
  • Ünal, N., & Gürhan, N. (2021). The effect of orthopedic operation on self-esteem, body image and state anxiety in patients. Acıbadem University Health Sciences Journal, 12(2), 392-400. https://doi.org/10.31067/acusaglik.852087.
  • Waniga, H. M., Gerke, T., Shoemaker, A., Bourgoine, D., & Eamranond, P. (2016). The impact of revised discharge instructions on patient satisfaction. Journal of Patient Experience, 3(3), 64–68. https://doi.org/10.1177/2374373516666972
  • WHO, 2010. A healthy lifestyle - WHO recommendations. https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations.
  • Yılmaz, E., & Toğaç, H. K. (2019). Effect of functional disability on quality of life in patients with gonarthrosis. Çukurova Medical Journal, 44(1), 308-316. https://doi.org/10.17826/cumj.562774

Ortopedik Cerrahi Girişim Sonrasında Hastaların Klinikte ve Evde Yaşadıkları Sorunlar ve Bakım Bağımlılık Düzeyleri

Yıl 2025, Cilt: 18 Sayı: 1, 56 - 72
https://doi.org/10.46483/jnef.1406445

Öz

Giriş: Ortopedik cerrahi girişim uygulanan hastaların bakım ihtiyaçları hastane ile sınırlı kalmayıp, taburculuk sonrası evde de devam etmektedir.
Amaç: Bu çalışmanın amacı, ortopedik cerrahi girişim uygulanan hastaların ameliyat sonrası klinikte ve taburculuk sonrası ilk ay evde yaşadıkları sorunların ve bakım bağımlılık düzeylerinin belirlenmesidir.
Yöntem: 1 Mart 2021 ile 18 Nisan 2022 tarihleri arasında bir devlet hastanesinin ortopedi ve travmatoloji kliniğinde yatan, ortopedik cerrahi girişim geçiren 18 yaş ve üzeri 113 hasta çalışmaya alındı. Veriler “Hasta Bilgi Formu (Bölüm I), İzlem Formu (Bölüm II)” ve “Bakım Bağımlılığı Ölçeği” kullanılarak toplandı. Veriler ortalama, standart sapma, medyan, minmum-maksimum, sayı ve yüzde, NcNemar, NcNemarBrowker, eta kare (η2), Cohen’s d, Kruskal Wallis-H testi, Dunn’s çoklu karşılaştırma tetsi ve Lineer regresyon analizi kullanılarak değerlendirildi.
Bulgular: Ortopedik cerrahi girişim geçiren hastaların en çok öz bakım ihtiyaçlarını karşılamada ve fiziksel hareket kısıtlılığında zorluk yaşadıkları belirlendi. Hastaların ağrı ve kaygılarının azalmasıyla iyileşme inancında artış, bağımlılık düzeylerinde ise azalma gözlendi. Lineer regresyon modelinde bakım bağımlılığındaki değişmelerin yalnızca %17’si bağımsız değişkenlerle açıklanabildi ancak bağımsız değişkenler istatistiksel olarak anlamlı saptanmadı.
Sonuç: Ortopedi hastaları yüksek düzeyde hareket kısıtlığı ve bakım bağımlılığı yaşamaktadır. Hastaların klinikteki üçüncü güne kıyasla taburculuktaki birinci ayda bakım bağımlılıklarında azalma görülmüştür.

Kaynakça

  • Acar, E. Z, & Fındık, Ü. Y. (2021). The problems of the patients that after surgery living at home and post-surgery patient’s problems at home on illness perception. Journal of Ege University Nursing Faculty (JEUNF), 37(3), 197-206. https://doi.org/10.53490/egehemsire.943140.
  • Akbari, A., Nasiri, A., & Amirabadizade, A. (2018). Effects of discharge education and telephone follow-up on pa-tient satisfaction and readmission after orthopedic surgery. Journal of Surgery and Trauma, 6(4), 122-127.
  • Akyüz, E., Ünlü, H., Uğurlu, Z., & Özhan Elbaş, N. H. (2021). Psychosocial problems and changes in quality of life experienced by patients who underwent orthopedic surgery. Health and Society, 31(3), 79-93.
  • Aydın, N., & Yılmaz, D. Ü. (2022). Investigation of nursing diagnosis of orthopedic patients by clinical practice students. Gümüşhane University Journal of Health Sciences, 11(1), 257-263.
  • Baksi, A., & Genç, H. (2020). Examination of care dependency of patients undergoing surgical intervention in terms of perception of care, sociodemographic and clinical characteristics. Turkiye Klinikleri Journal of Nursing Sci-ences, 12(4), 465-72. https://doi.org/10.5336/nurses.2020-75291.
  • Bektaşoğlu, B., & Eyi, S. (2021). Care according to kolcaba’s comfort theory in individuals undergoing lower ex-tremity surgery. Journal of Nursing Science, 4(3), 148-155. https://doi.org/10.54189/hbd.875287.
  • Bilik, Ö. (2017). Travel to home from the clinic: home care of the surgery patients. Journal of Ege University Nurs-ing Faculty (JEUNF), 3381), 114-127.
  • Ciğerci, Y., Özdemir, H., & Kılıç, İ. (2016). The patient safety culture perception of surgery nurses and its relation-ship with sociodemographic characteristics. Journal of Duzce University Health Sciences Institute, 6(3), 149-153.
  • Dinçer, A., & Kurşun, Ş. (2019). Determining the problems experienced by the elderly at home after (following) surgical interventions. Acıbadem University Health Sciences Journal, 10(3), 518-523. https://doi.org/10.31067/0.2019.184.
  • Doroszkiewicz, H., Sierakowska, M., & Muszalik, M. (2018). Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients. Clinical Interventions in Aging, 8(13), 887–894. https://doi.org/10.2147/CIA.S159511
  • Durgun, H., Duman, S., & Şahin, K. (2022). Investigation of dependence levels and perceptions of nursing care of inpatients in surgical and medical services. Journal of Nursology, 25(1), 31-35. https://doi.org/10.54614/JANHS.2022.688251.
  • Gosens, T., & den Oudsten, B. L. (2023). Psychology in orthopedics and traumatology: an instructional review. EFORT open reviews, 8(5), 245–252. https://doi.org/10.1530/EOR-23-0038
  • Gürler, H. (2021). Care requirements of patients undergoing surgery intervention due to the femur fracture accord-ing to functional health patterns model. Journal of Education and Research in Nursing, 18(4), 415-422. https://doi.org/10.5152/jern.2021.05925
  • Yönt, GH., A. Korhan, E., Khorshid, L., Eşer, İ., & Dijkstra, A. (2010). Examining the validity and reliability of the care dependency scale in elderly individuals. Turkish Journal of Geriatrics, Special Issue, (13), 71.
  • Hauer, G., Sadoghi, P., Smolle, M., Zaussinger, S., Friesenbichler, J., Leithner, A., & Maurer-Ertl, W. (2023). Sex-ual activity after short-stem total hip arthroplasty. Does stem size matter? Archives of Orthopaedic and Trauma Surgery, 143(6), 3613–3619. https://doi.org/10.1007/s00402-022-04614-y
  • Hijji, F. Y., Cheslik, T. G., Schneider, A. D., Schach, B. M., & Venkatarayappa, I. (2021). The popularity of out-come measures used in shoulder arthroplasty literature. Shoulder & Elbow, 13(3), 237–247. https://doi.org/10.1177/1758573220935865
  • Imeni, M., Sabouhi, F., Abazari, P., & Iraj, B. (2018). The effect of spiritual care on the body image of patients un-dergoing amputation due to Type 2 Diabetes: A randomized clinical trial. Iranian Journal of Nursing and Midwifery Research, 23(4), 322–326. https://doi.org/10.4103/ijnmr.IJNMR_113_15
  • Kalantar, S., Farhoud, A., & Mortazavi, J. (2020). Lockdown of an orthopedic department during COVID-19 epi-demics, our experience in a general hospital. The Archives of Bone and Joint Surgery, 8(Suppl1), 235–241. https://doi.org/10.22038/abjs.2020.47834.2362
  • Karakoç, Y., & Atalay, İ. B. (2019). The role of magnetic resonance imaging and clinical assessments in predicting meniscal tear surgery. Joint Diseases and Related Surgery, 30(2), 85-90. https://doi.org/10.5606/ehc.2019.66962
  • Kılıç, H. F., Cevheroğlu, S., & Görgülü, S. (2017). Determination of care dependency level of patients staying in medical and surgical clinics. E-Journal of Dokuz Eylul University Nursing Faculty, 10(1), 22-28.
  • Koç, S., Büker, N., Şavkın, R., & Kıter, E. (2012). The effects of independence and depression level on patients’ satisfaction with nursing care in orthopedics and traumatology patients. The Journal of Kartal Training and Re-search Hospital, 23(3), 130-136. https://doi.org/10.5505/jkartaltr.2012.49092
  • Kubat Bakır, G., & Yurt, S. (2020). Evaluation of the comfort level of the post-surgical patients. Health and Socie-ty, 20(3), 158-165.
  • Martin, C., Parellada, C., Vez, H., Urgiles, C., Piedra, J., & Guix, J. (2022). Telemedicine Approach for Patient Fol-low-up After Total Knee and Reverse Total Shoulder Arthoplasty: A pilot Study. International Journal of Computer Assisted Radiology and Surgery, 18(3), 598-602.
  • Neonakis, E. M., Perna, F., Traina, F., Faldini, O., Antoniou, G., Kyriakopoulos, G., Triantafyllopoulos, I. K., Megaloikonomos, P. D., & Faldini, C. (2020). Total hip arthroplasty and sexual activity: a systematic review. Mus-culoskeletal Surgery, 104(1), 17–24. https://doi.org/10.1007/s12306-020-00645-z
  • Ozveren, H., Faydali, S., Sasmaz, S., F. Dokuz, H., & Gulnar, E. (2021). Care dependency and quality of life in old-er adult patients. International Journal of Caring Sciences, 14(1), 319-325.
  • Rocha, P., Baixinho, C. L., Marques, A., & Henriques, A. (2022). Safety-Promoting interventions for the older per-son with hip fracture on returning home: A protocol for a systematic review. Journal of Personalized Medicine, 12(5), 654. https://doi.org/10.3390/jpm12050654
  • Rougereau, G., Rabot, C., de Thomasson, E., Tourabaly, I., Mazel, C., Langlais, T., & Ollat, D. (2022). Sexual ac-tivity resumption after total hip arthroplasty: A satisfaction survey in 101 patients. Orthopaedics & Traumatology, Surgery & Research: OTSR, 108(1), 103171. https://doi.org/10.1016/j.otsr.2021.103171
  • Silva, M. B., Palma, M., Engelman, B., Figueiredo, M. S., & Abreu Almeida, M. (2021). Positioning of orthopedic patients according to the nursing outcomes classidic ation. J Nurs. UFPE On Line, 15(2), https://doi.org/10.5205 / 1981-8963.2021.245744
  • T. Damar, H., & Bilik, Ö. (2018). Pain intensity and the affecting factors in elderly patients with arthroplasty sur-gery. Journal of Geriatric Science, 1(3), 104-112.
  • Turan, N., & Sendir, M. (2019). Defining care needs for inpatients in the orthopaedics and traumatology clinic. In-ternational Journal of Caring Sciences, 12(2), 1001-1007
  • Ünal, N., & Gürhan, N. (2021). The effect of orthopedic operation on self-esteem, body image and state anxiety in patients. Acıbadem University Health Sciences Journal, 12(2), 392-400. https://doi.org/10.31067/acusaglik.852087.
  • Waniga, H. M., Gerke, T., Shoemaker, A., Bourgoine, D., & Eamranond, P. (2016). The impact of revised discharge instructions on patient satisfaction. Journal of Patient Experience, 3(3), 64–68. https://doi.org/10.1177/2374373516666972
  • WHO, 2010. A healthy lifestyle - WHO recommendations. https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations.
  • Yılmaz, E., & Toğaç, H. K. (2019). Effect of functional disability on quality of life in patients with gonarthrosis. Çukurova Medical Journal, 44(1), 308-316. https://doi.org/10.17826/cumj.562774
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi Hastalıklar Hemşireliği, Halk Sağlığı Hemşireliği, Hemşirelikte Yönetim
Bölüm Araştırma Makalesi
Yazarlar

Elif Akyazı 0000-0003-4150-5630

Aygül Kıssal 0000-0003-4570-5031

Erken Görünüm Tarihi 15 Ocak 2025
Yayımlanma Tarihi
Gönderilme Tarihi 18 Aralık 2023
Kabul Tarihi 17 Ekim 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 18 Sayı: 1

Kaynak Göster

APA Akyazı, E., & Kıssal, A. (2025). Problems Experienced by Patients in the Clinic and at Home after Orthopedic Surgery and Their Level of Care Dependency. Etkili Hemşirelik Dergisi, 18(1), 56-72. https://doi.org/10.46483/jnef.1406445

Etkili Hemşirelik Dergisi ULAKBİM Türk Tıp Dizini, Türk Medline, Türkiye Atıf Dizini, Şubat 2021 tarihinden beri EBSCO Host ve 26 Ekim 2021 tarihinden itibaren DOAJ ve 18 Ocak 2022 tarihinden beri Index Copernicus, 14 Kasım 2022 tarihinden beri SCOPUS tarafından indekslenmektedir.

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https://kutuphane.deu.edu.tr/yayinevi/

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https://dergipark.org.tr/tr/pub/jnef/contacts

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