Düzeltme: Total Kalça Artroplastisi Uygulanan Yaşlı Hastanın Evde Bakım Yönetimi - Olgu Sunumu

Yıl 2025, Cilt: 4 Sayı: 1, 80 - 92, 30.04.2025

Mehmet Dalkılıç , Özlem Bilik

Öz

Total kalça artroplastisi (TKA), eklem ağrısının giderilmesi, eklem hareketliliğinin stabilizasyonu ve yaşam kalitesinin artırılması amacıyla uygulanan bir ortopedik cerrahi girişimdir. Konservatif tedavi yöntemleri, fizik tedavi ve rehabilitasyonun yetersiz kaldığı durumlarda tercih edilen bu cerrahi prosedür, özellikle yaşlı bireylerde fonksiyonel bağımsızlığı artırma potansiyeline sahiptir. Yaşlanan nüfus ve artan yaşam beklentisi göz önüne alındığında, TKA’nın bireylerin yaşam kalitesine sağladığı katkılar giderek daha fazla önem kazanmaktadır.
Hemşirelik, bireylerin sağlığının korunması, geliştirilmesi ve hastalıkların önlenmesine yönelik temel roller üstlenirken, postoperatif dönemde hasta ve hasta yakınlarına rehberlik etmek açısından da kritik bir meslek disiplinidir. Hemşireler, hastaların günlük yaşam aktivitelerine yeniden adapte olmalarını sağlamak amacıyla eğitim ve destek programları sunmalı, aynı zamanda motivasyonel görüşmeler aracılığıyla bireylerin rehabilitasyon sürecine uyumlarını teşvik etmelidir. Ağrı yönetimi ve rehabilitasyon süreçleri, cerrahi sonrası dönemde hastaların genel iyilik hali üzerinde belirleyici faktörler arasında yer almaktadır. Bu derleme, total kalça artroplastisi uygulanmış 82 yaşındaki bir kadın hastanın bakım süreci ve taburculuk eğitimi üzerine odaklanmaktadır. Hastanın sağlığının korunması, geliştirilmesi ve yaşam tarzında gerekli değişikliklerin sağlanmasına yönelik uygulanan hemşirelik girişimleri detaylandırılarak sunulmuştur.

Anahtar Kelimeler

olgu sunumu , total kalça artroplastisi , hemşirelik süreci , taburculuk planı , evde bakım

Etik Beyan

ÇALIŞMAMIZ İÇİN ETİK İZİN GEREKLİ DEĞİLDİR.

Destekleyen Kurum

Herhangi bir destek kaynağımız yoktur.

Teşekkür

YOKTUR.

Düzeltme: Home Care Management of an Elderly Patient with Total Hip Arthroplasty - Case Report

Öz

Total hip arthroplasty (THA) is an orthopaedic surgical procedure performed to relieve joint pain, stabilise joint mobility and improve quality of life. This surgical procedure, which is preferred in cases where conservative treatment methods, physical therapy and rehabilitation are insufficient, has the potential to increase functional independence, especially in elderly individuals. Considering the ageing population and increasing life expectancy, the contribution of THA to the quality of life of individuals is becoming increasingly important. Nursing is a critical professional discipline in terms of guiding patients and their relatives in the postoperative period, while undertaking basic roles in protecting and improving the health of individuals and preventing diseases. Nurses should provide education and support programmes to enable patients to re-adapt to activities of daily living, as well as encourage individuals to adapt to the rehabilitation process through motivational interviews. Pain management and rehabilitation processes are among the determining factors on the general well-being of patients in the postoperative period. This review focuses on the care process and discharge education of an 82-year-old female patient who underwent total hip arthroplasty. Nursing interventions applied to protect and improve the patient's health and to provide the necessary changes in lifestyle are detailed.

Anahtar Kelimeler

Case presentation , total hip arthroplasty , nursing process , discharge planning , home care

Kaynakça

• Acar, E. Z., & Fındık, Ü. Y. (2021). Ameliyat sonrası hastaların evde yaşadıkları sorunlar ve ameliyat sonrası hastaların evde yaşadıkları sorunların hastalık algısına etkisi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 37(3), 197-206.
• Ağar, A. (2020). Yaşlılarda ortaya çıkan psikolojik değişiklikler. Geriatrik Bilimler Dergisi, 3(2), 75-80.
• Akpınar, H. (2019). Geriatrik hastaların diş tedavisinde anestezi yönetimi. Anesteziyoloji ve Reanimasyon Uzmanları Derneği Dergisi.
• Alkan, Ş. B., & Rakıcıoğlu, N. (2020). Demans ve polifenoller. Sağlık ve Toplum, 30(3), 11-20.
• Ashiq, U., Abbas, N., Sajid, I. U., & Shafiq, M. (2023). Effects of covid-19 on mental health of older adults: study based on perceptions and experiences of adults suffered from covid-19. Pakistan Journal of Medical and Health Sciences, 17(3), 64-66. https://doi.org/10.53350/pjmhs202317364
• Australian Orthopaedic Association. (2021). Australian National Joint Replacement Registry annual report. Retrieved from https://aoanjrr.sahmri.com/annual-reports-2021
• Balkan, A. and Seki, Z. (2021). Determination of complications of patients undergoing total hip replacement after discharge. Black Sea Journal of Health Science, 4(2), 141-149. https://doi.org/10.19127/bshealthscience.802798
• Baytaş, V., Aliyev, D., Erkoç, S. K., Turhan, S. Ç., & Ökten, F. (2022). Alt ekstremite artroplasti girişimlerinden sonra gelişen kronik ağrı üzerine hasta özelliklerinin ve perioperatif koşulların etkisi: 3 yıllık klinik sonuçların retrospektif analizi. Turkiye Klinikleri Journal of Anesthesiology Reanimation, 20(2), 57-63. https://doi.org/10.5336/anesthe.2022-90459
• Campani, D., Caristia, S., Amariglio, A., et al. (2020). Home and environmental hazards modification for fall prevention among the elderly. Public Health Nursing, 38(3), 493-501. https://doi.org/10.1111/phn.12852
• Çığlı, B., & Uğraş, G. A. (2022). Total kalça protezli hastalarda video destekli eğitimin kalça fonksiyonu ve günlük yaşam aktiviteleri üzerindeki etkisi: Randomize kontrollü çalışma. Turkiye Klinikleri Journal of Nursing Sciences, 14(4), 954-964.
• Dautzenberg, L., Beglinger, S., Tsokani, S., et al. (2021). Interventions for preventing falls and fall‐related fractures in community‐dwelling older adults: a systematic review and network meta‐analysis. Journal of the American Geriatrics Society, 69(10), 2973-2984. https://doi.org/10.1111/jgs.17375
• Deveci, M., & Aslan, L. (2021). Yaşlı intertrokanterik kalça kırıklarının bakımı: Kanıta dayalı tıp ve güncel literatür. TOTBID Dergisi, 20(2).
• ERAS. (2019). Ameliyat sonrası iyileşmenin iyileştirilmesi: Perioperatif bakım için yönergeler. Retrieved from https://www.erassociety.org
• Erivan, R., Villatte, G., Dartus, J., Reina, N., Descamps, S., & Boisgard, S. (2019). Progression and projection for hip surgery in France, 2008–2070: Epidemiologic study with trend and projection analysis. Orthopaedics & Traumatology: Surgery & Research, 105(7), 1227–1235. https://doi.org/10.1016/j.otsr.2019.07.021
• Ferguson, R. J., Palmer, A. J., Taylor, A., Porter, M. L., Malchau, H., & Glyn-Jones, S. (2018). Hip replacement. The Lancet, 392(10158), 1662–1671. https://doi.org/10.1016/S0140-6736(18)31777-X
• Fu, W., Hu, Z., Liao, Y., et al. (2024). Relationship between preoperative psychological stress and short-term prognosis in elderly patients with femoral neck fracture. World Journal of Psychiatry, 14(6), 838–847. https://doi.org/10.5498/wjp.v14.i6.838
• Gencer, G. Y. G., İpek, L., Kara, D. S., Uzun, F., & Çetin, S. Y. (2020). Türkiye'de yaşlılarda düşme ve denge ile kaçakçılık görülen kişilerin incelenmesi. Yaşlı Sorunları Araştırma Dergisi, 14(2), 70-83.
• Genel, F., Pavlovic, N., Gao, M., et al. (2024). Optimising body weight in people with obesity prior to knee or hip arthroplasty: a feasibility study utilising a dietitian‐led low inflammatory diet. Musculoskeletal Care, 22(1). https://doi.org/10.1002/msc.1867
• Hackett, R. A., Steptoe, A., Cadar, D., & Fancourt, D. (2019). Social engagement before and after dementia diagnosis in the English Longitudinal Study of Ageing. PLOS ONE, 14(8), e0220195. https://doi.org/10.1371/journal.pone.0220195
• Hamouzová, D., & Navrátil, L. (2023). Effectiveness of telerehabilitation in patients following hip joint arthroplasty. Kontakt, 25(3), 235-245. https://doi.org/10.32725/kont.2023.036
• Heo, S. C., Ahn, H. Y., Shin, R., Lim, C., & Han, D. (2020). Risk factors of elderly patients with postoperative delirium following major abdominal surgery for cancer. Korean Journal of Clinical Oncology, 16(2), 104-109.
• Huang, Y., Wu, R., Xia, Q., Liu, L., & Feng, G. (2023). Prognostic values of geriatric nutrition risk index on elderly patients after spinal tuberculosis surgery. Frontiers in Nutrition, 10. https://doi.org/10.3389/fnut.2023.1229427
• Jones, E. D., Davidson, L. J., & Cline, T. W. (2022). The effect of preoperative education prior to hip or knee arthroplasty on immediate postoperative outcomes. Orthopaedic Nursing, 41(1), 4-12. https://doi.org/10.1097/nor.0000000000000814
• Kahraman, H., & Kurşun, Ş. (2022). Cerrahi kliniklerde çalışan hemşirelerin ameliyat öncesi hasta eğitimini uygulama durumları. Genel Sağlık Bilimleri Dergisi, 4(3), 258–268. https://doi.org/10.51123/jgehes.2022.62
• Karslıoğlu, B., Bayraktar, T. O., & İmren, Y. (2021). Management of painful hip after elderly hip fracture surgery. TOTBİD Dergisi, 20, 244–248.
• Kim, I. and Hegazy, F. A. (2024). Enhancing footwear safety for fall prevention in older adults: a comprehensive review of design features. Annals of Geriatric Medicine and Research, 28(2), 121-133. https://doi.org/10.4235/agmr.23.0167
• Kinoshita, T., Nishimura, Y., Umemoto, Y., et al. (2022). Case report: rehabilitation for lower extremity pain due to venous stasis in a patient with multisystem inflammatory syndrome in children. Frontiers in Pediatrics, 9. https://doi.org/10.3389/fped.2021.810811
• Ko, Y., Lee, J., & Baek, S. H. (2020). Discharge transition experienced by Korean older adults after hip fracture surgery: A qualitative study. BMC Geriatrics, 20(1), 1-10. https://doi.org/10.1186/s12877-020-01875-5
• Koseki, K., Mutsuzaki, H., Yoshikawa, K., et al. (2019). Gait training using the Honda Walking Assistive Device® in a patient who underwent total hip arthroplasty: A single-subject study. Medicina, 55(3), 69.
• Krüger, K., Davidson, S., Krepp, J., & Berstein, L. (2019). Deep vein thrombosis: Update on diagnosis and management. The Medical Journal of Australia, 210(11), 516-523. https://doi.org/10.5694/mja2.50201
• Lecouvet, C., Géradon, P., Banse, X., Rausin, G., Guyot, N., & Lecouvet, F. (2024). Non-traumatic complete cervical spine dislocation with severe fixed kyphosis: successful multidisciplinary approach to a challenging case. Journal of Medical Case Reports, 18(1). https://doi.org/10.1186/s13256-024-04446-x
• Lee, H., Lee, Y., & Yun, J. (2020). Factors associated with physical activity in older adults by region: based on the 2017 community health survey. Journal of Korean Academy of Community Health Nursing, 31(Suppl), 563. https://doi.org/10.12799/jkachn.2020.31.s.563
• Li, X., Tsolis, K. C., Koper, M. J., et al. (2021). Sequence of proteome profiles in preclinical and symptomatic Alzheimer's disease. Alzheimer's & Dementia, 17(6), 946-958.
• Liu, Q., Li, L., & Xie, Y. (2023). Correlation and influencing factors of preoperative anxiety, postoperative pain, and delirium in elderly patients undergoing gastrointestinal cancer surgery. https://doi.org/10.21203/rs.3.rs-2389140/v1
• Macwan, A. A., Nanda, S. N., Mishra, D., Manthena, S. A. V., & Gulia, A. (2021). Dual mobile total hip replacement in super obesity: a case report and review of literature. Journal of Orthopaedic Case Reports, 11(10). https://doi.org/10.13107/jocr.2021.v11.i10.2486
• Meşe, S., & Köşgeroğlu, N. (2021). Cerrahi hastalara özgü taburculuk eğitimi memnuniyet ölçeği'nin geliştirilmesi. Turkiye Klinikleri Journal of Nursing Sciences, 13(4), 759–768. https://doi.org/10.5336/nurses.2021-81078
• Mohammed, H. S., Shehata, A. E., Fareed, M. E., & El-Sayad, H. E. (2023). Effect of pre and postoperative nursing intervention on pain and postoperative complications among patients undergoing hip replacement. Menoufia Nursing Journal, 8(2), 1-17.
• Mosti, G., Wittens, C. H., & Caggiati, A. (2024). Black holes in compression therapy: a quest for data. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 12(2), 101733. https://doi.org/10.1016/j.jvsv.2023.101733
• Mulyati, M. I., & Exposto, L. A. S. (2022). An analysis of bathroom and toilet interior design according to the capacity of the elderly. KESANS: International Journal of Health and Science, 1(6), 687–697. https://doi.org/10.54543/kesans.v1i6.73
• Murakami, H., Seo, S., Ochi, T., Yazaki, Y., Takeda, M., & Yamataka, A. (2021). A useful tip for preventing surgical site infections after hypospadias repair. a single surgeon's experience of 376 cases. African Journal of Paediatric Surgery, 18(1), 5-8. https://doi.org/10.4103/ajps.ajps_17_18
• National Joint Registry. (2017). Public and patient guide to the main NJR annual report. Retrieved from http://www.njrcentre.org.uk/njrcentre/Reports,PublicationsandMinutes/PublicandPatientGuide/tabid/231/Default.aspx
• Özcan, G., & Kurşun, Ş. (2021). Cerrahi girişim geçiren yaşlı hastaların hemşirelik bakım kalitesini algılaması. Güncel Hemşirelik Araştırmaları Dergisi, 1(3), 107-116.
• Petersen, P. B., Kehlet, H., & Jørgensen, C. C. (2020). Improvement in fast-track hip and knee arthroplasty: A prospective multicentre study of 36,935 procedures from 2010 to 2017. Scientific Reports, 10(1), 21233. https://doi.org/10.1038/s41598-020-78238-1
• Pol, M., Peek, S., van Nes, F., van Hartingsveldt, M., Buurman, B., & Kröse, B. (2019). Everyday life after a hip fracture: What community-living older adults perceive as most beneficial for their recovery. Age and Ageing, 48(3), 440-447.
• Prince, M., Albanese, E., Guerchet, M., & Prina, M. (2014). World Alzheimer Report 2014: Dementia and risk reduction: An analysis of protective and modifiable risk factors. Alzheimer's Disease International. https://www.alzint.org/resource/world-alzheimer-report-2014/
• Quinn, C., Hart, N., Henderson, C., Litherland, R., Pickett, J., & Clare, L. (2021). Developing supportive local communities: Perspectives from people with dementia participating in the IDEAL programme. Dementia, 20(5), 1580-1597. https://doi.org/10.1177/1471301221990598
• Reckrey, J. M., Boerner, K., Franzosa, E., Bollens-Lund, E., & Ornstein, K. A. (2021). Paid caregivers in the community-based dementia care team: Do family caregivers benefit? Clinical Therapeutics, 43(6), 930-941. https://doi.org/10.1016/j.clinthera.2021.03.022
• Rodríguez, R. M. M., Gómez, B. S., Marcuello, L. G., Martinez, M. d. C. D., Palacio, E. F. d., & Santiago‐Sáez, A. (2023). Observational prospective study to determine the efficacy of ‘non-slip socks’ vs. ‘adequate footwear’ regarding the number of falls observed among admitted patients. Healthcare, 11(19), 2605. https://doi.org/10.3390/healthcare11192605
• Sadiq, S., Ahmad, A., Ahmed, A., Khan, I., Asim, H. M., & Aziz, A. (2022). Role of tele-rehabilitation in patients following total hip replacement: Systematic review of clinical trials. Journal of Pakistan Medical Association, 72(1), 101-101.
• Soedirman, B. S. and Laksmidewi, A. A. A. P. (2021). Benefit of cognitive stimulation therapy in a patient with vascular dementia: a case report. Open Access Macedonian Journal of Medical Sciences, 9(C), 10-14. https://doi.org/10.3889/oamjms.2021.5585
• Song, K., Ko, J., Kwon, T., & Choi, B. (2019). Etiology and related factors of postoperative delirium in orthopedic surgery. Clinics in Orthopedic Surgery, 11(3), 297. https://doi.org/10.4055/cios.2019.11.3.297
• Songthap, A., Suphunnakul, P., & Rakprasit, J. (2023). Factors affecting home environmental safety management for fall prevention for older adults in northern thailand. BMC Geriatrics, 23(1). https://doi.org/10.1186/s12877-023-04419-7
• Sun, X., Zhu, X., Zeng, Y., et al. (2020). The effect of posterior capsule repair in total hip arthroplasty: A systematic review and meta-analysis. BMC Musculoskeletal Disorders, 21(1). https://doi.org/10.1186/s12891-020-03244-y
• Tandon, R., Sharma, S., Thakur, M., & Gupta, R. (2024). A descriptive study to determine anxiety and depression among hospitalized elderly undergoing abdominal surgery admitted at the Surgery Unit of Nehru Hospital, PGIMER, Chandigarh. Journal of Nursing and Midwifery Research, 20(2), 73–81.
• Thomas, D. G., Bradley, L., Servi, A., et al. (2018). Parent knowledge and recall of concussion discharge instructions. Journal of Emergency Nursing, 44(1), 52–56. https://doi.org/10.1016/j.jen.2017.04.014
• Türkiye İstatistik Kurumu (TÜİK). (2020). Retrieved from https://www.tuik.gov.tr
• Umetsu, M., Akamatsu, D., Serizawa, F., et al. (2022). Anticoagulation therapy for pregnancy-associated thrombosis: a retrospective observational study. Annals of Vascular Diseases, 15(4), 317-323. https://doi.org/10.3400/avd.oa.22-00083
• Weng, Q., Goh, S., Wu, J., Persson, M., Wei, J., Sarmanova, A., … & Zhang, W. (2023). Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: A network meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 57(15), 990-996.
• Yan, C., Yang, M., Niu, N., Li, L., & Pan, L. (2021). The influencing factors of postoperative delirium in elderly hip fracture patients: What should treatment focus on? https://doi.org/10.21203/rs.3.rs-944711/v1
• Yanyan, B., Kaiyuan, C., Xiao, C., & Xisheng, W. (2020). Çin'de 2011'den 2019'a kadar kalça ve diz artroplastisi miktarının raporları ve analizi. Chin J Orthop, 40(21), 1453–1460.
• Yaradılmış, Y. U., Taşkesen, A., Kılıçarslan, K., Asiltürk, M., Demirkale, İ., & Altay, M. (2019). Anesthesia type have the effect of extremity length award in patients with total hip artroplasty?. Ortadoğu Tıp Dergisi, 11(4), 433-438. https://doi.org/10.21601/ortadogutipdergisi.519877
• Yıldız, F., & Ağır, M. (2021). Hangi kalça kırığında endoprotez; parsiyel mi, toplam mı? TOTBID Dergisi, 20(2), 85–92.
• Yılmaz, E., & Toğaç, H. K. (2019). Gonartrozlu hastalarda fonksiyonel yetersizliğin yaşam kalitesine etkisi. Cukurova Medical Journal, 44, 308-316. https://doi.org/10.17826/cumj.562774
• Zhu, S., Ma, Z., Ge, Y., & Yuan, L. (2023). Risk factors for postoperative delirium in elderly patients after major orthopedic surgery: A prediction model. https://doi.org/10.21203/rs.3.rs-2546682/v1
• Zhang, Y., Zhang, L., Wang, L. P., & Zhang, Z. Y. (2023). Efficacy of ultrasound-guided quadratus lumborum block in postoperative analgesia of total hip replacement. Indian Journal of Pharmaceutical Sciences, 85(S2). https://doi.org/10.36468/pharmaceutical-sciences.spl.662