Interventions of the nursing diagnosis „Acute Pain“ – Evaluation of patients' experiences after total hip arthroplasty compared with the nursing record by using Q-DIO-Pain: a mixed methods study
Background: Pain affects patients' rehabilitation after hip replacement surgery. Aim: The study aim was to compare patients' responses, on their received pain relieving nursing interventions after hip replacement surgery, with the documented interventions in their nursing records. Method: A mixed methods design was applied. In order to evaluate quantitative data the instrument „Quality of Diagnoses, Interventions and Outcomes“ (Q-DIO) was further developed to measure pain interventions in nursing records (Q-DIO-Pain). Patients (n = 37) answered a survey on the third postoperative day. The patients' survey findings were then compared with the Q-DIO-Pain results and cross-validated by qualitative interviews. Results: The most reported pain level was „no pain“ (NRS 0 – 10 Points). However, 17 – 50 % of patients reported pain levels of three or higher and 11 – 22 % of five or higher in situations of motion / ambulation. A significant match between patients' findings and Q-DIO-Pain results was found for the intervention „helping to adapt medications“ (n = 32, ICC = 0.111, p = 0.042, CI 95 % 2-sided). Otherwise no significant matches were found. Interviews with patients and nurses confirmed that far more pain-relieving interventions affecting „Acute Pain“ were carried out, than were documented. Conclusions: Based on the results, pain assessments and effective pain-relieving interventions, especially before or after motion / ambulation should be improved and documented. It is recommended to implement a nursing standard for pain control.
1 Institut für Pflege, Zürcher Hochschule für Angewandte Wissenschaften (ZHAW) Gesundheit.
David C
DC
Zanon
1 Institut für Pflege, Zürcher Hochschule für Angewandte Wissenschaften (ZHAW) Gesundheit.
Dieter
D
Gralher
1 Institut für Pflege, Zürcher Hochschule für Angewandte Wissenschaften (ZHAW) Gesundheit.
Maria
M
Müller-Staub
D059787:Acute Pain / Q000175:diagnosis / Q000451:nursing*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000451:nursing*; D004282:Documentation / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009733:Nursing Diagnosis; D009737:Nursing Records; D015207:Osteoarthritis, Hip / Q000451:nursing* / Q000601:surgery*; D059408:Pain Management / Q000379:methods / Q000451:nursing*; D010147:Pain Measurement / Q000379:methods / Q000451:nursing*; D010149:Postoperative Pain / Q000175:diagnosis / Q000451:nursing*; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires
Hüftendoprothesenversorgung; NANDA International Nursing Diagnosis; Pflegediagnosen NANDA-International; Pflegedokumentation; Q-DIO-Pain; acute postoperative pain; akute postoperative Schmerzen; arthroplasty; hip replacement; nursing records