Study On The Effect Of Pain Nursing Management In Patients After Total Knee Arthroplasty

Objective: To explore the effect of pain nursing management on patients after total knee arthroplasty,and to provide effective reference value for clinical nursing.Methods: A total of 92 patients who underwent total knee arthroplasty and met the criteria were enrolled at a upper first-class general hospital orthopedic department in south of China from March 2015 to October 2016.According to the order of admission,patients from March to December 2015(n=45)were treated with routine nursing as the control group.Patients from January to October 2016(n = 47)were treated with the intervention of pain nursing management which was on the basis of routine nursing.First register the patient's general information,including age,sex,educational level,anesthesia,surgical site,payment methods,hospital stay,body mass index etc.The age,hospital stay,body mass index and other measurement data were analyzed by t test of two independent samples treatment.Sex,educational level,anesthesia,surgical site,payment methods and other counting data were used chi-square test for statistical treatment.The improvement of anxiety and depression preoperative and postoperative one week of the two groups were evaluated by the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS).The resting pain and exercise pain of the two groups were evaluated by visual analogue scale(VAS).The Pittsburgh Sleep Quality Index(PSQI)was used to assess the quality of sleep in both groups before and one week postoperatively.The HSS score was used to evaluate the recovery of knee function in the two groups before operation,discharge and the first month after discharge.The above measurement data were processed using two independent samples of the t test,and compare the effect of intervention group and control group of patients.Results: 1.There was no statistical difference between the two groups in age,sex,educational level,anesthesia,surgical site,payment method and body mass index(P> 0.05).2.Comparison of anxiety(SAS)between preoperative and postoperative one week in both groups: the SAS scores of the two groups patients before surgery was higher,there was no statistical differences in SAS scores between the two groups(P> 0.05);the SAS scores between the two groups of patients postoperative one week was significant different(P <0.01).3.Comparison of depression(SDS)between preoperative and postoperative one week in both groups: the SDS scores of the two groups patients before surgery was higher,there was no statistical difference in SDS scores between the two groups(P> 0.05);the SDS scores between the two groups of patients postoperative one week was significant different(P <0.01).4.The resting pain and exercise pain of the two groups were compared preoperative and postoperative 24 h,48h and 72h: there were no statistical differences in rest pain and exercise pain between the two groups before operation(P> 0.05).In terms of rest pain,there were significant statistical differences in rest pain for patients at 24 h,72h after operation(P<0.01).There was statistical difference in rest pain for patients at 48 h after operation(P <0.05).In terms of rest pain,there were significant statistical differences in exercise pain for patients at 24 h,72h after operation(P<0.01).5.Comparison of sleep quality(PSQI)between preoperative and postoperative one week in both groups: the PSQI scores of the two groups were higher before operation.There were no statistical differences in PSQI scores between the two groups(P> 0.05)in sleep quality,sleep time,sleep efficiency,sleep disturbance,daytime function,hypnotic drugs and total scores.There were statistical differences in the two groups of patients postoperative one week in sleep quality,sleep time,sleep efficiency,sleep disturbance(P <0.05).There were significant statistical differences in daytime function and total scores(P <0.01),but there was no significant statistical difference in the use of hypnotic drugs between the two groups(P> 0.05).6.Two groups of patients' hospital stay and before operation,discharge,the first month after discharge of the knee function recovery compared: the two groups of patients in terms of hospital stay,the number of hospitalizations in the intervention group was shorter than that in the control group(P <0.05).There was no statistical difference between the two groups in the preoperative HSS score(P> 0.05).There was significant statistical difference in HSS scores at discharge(P <0.01).There was statistical difference in HSS scores at the first month after discharge(P <0.05).Conclusion: pain nursing management can help TKA patients to reduce postoperative pain,improving patients' sleep quality,reducing the degree of postoperative anxiety and depression in patients with TKA.It is also conductive to the early recovery of knee function and reduce the time of hospital stay.