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Xu Y, Chen X, Li X, Liu F, Deng C, Jia P, Liu YY, Xie C. Influencing factors of kinesiophobia in knee arthroplasty patients under the social cognitive theory: A structural equation model. Geriatr Nurs 2024; 60:270-280. [PMID: 39342894 DOI: 10.1016/j.gerinurse.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/31/2024] [Accepted: 09/01/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVE To analyze the path relationships among influencing factors for kinesiophobia in knee arthroplasty patients through a structural equation model. BACKGROUND The occurrence of kinesiophobia significantly impacts the rehabilitation process of knee arthroplasty patients. However, there is still a need to determine factors that contribute to reducing kinesiophobia. DESIGN A cross-sectional study was conducted and reported following the STROBE guideline. METHODS Between February 2022 to October 2022, 162 total knee arthroplasty (TKA) patients and 81 unicompartmental knee arthroplasty (UKA) patients completed a survey. A structural equation modeling (SEM) approach was utilized to analyze the relationships between kinesiophobia and influencing factors (social support, pain resilience, and rehabilitation self-efficacy). Furthermore, multi-group SEM analysis was conducted to examine whether the model equally fitted patients in different types of knee arthroplasty. RESULTS The direct negative effects of rehabilitation self-efficacy (β = -0.535) and pain resilience (β = -0.293) on kinesiophobia were observed. The mediating effect (β = -0.183) of pain resilience and rehabilitation self-efficacy between social support and kinesiophobia was also significant. The SEM model achieved an acceptable model fit (χ2 = 35.656, RMSEA = 0.031, χ2/df = 1.230, GFI = 0.972, NFI = 0.982, IFI = 0.997, CFI = 0.996). In multicohort analysis, no significant differences were observed among knee arthroplasties (TKA, UKA) (Δχ2 = 4.213, p = 0.648). CONCLUSIONS Satisfactory social support enhances pain resilience and rehabilitation self-efficacy, so as to reduce kinesiophobia. Future interventions that directly target the assessment and management of kinesiophobia, available social support may help reduce kinesiophobia, and pain resilience and rehabilitation self-efficacy may be critical factors in managing kinesiophobia. RELEVANCE TO CLINICAL PRACTICE Reducing kinesiophobia in knee arthroplasty patients requires satisfactory social support, pain resilience, and rehabilitation self-efficacy. Therefore, healthcare organizations may implement initiatives to reduce kinesiophobia by taking these factors into account.
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Affiliation(s)
- Yaqin Xu
- Orthopedics Department, Qionglai Medical Center Hospital, 611530, PR China; Medical School, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, PR China
| | - Xia Chen
- Nursing Department, Qionglai Medical Center Hospital,611530, PR China
| | - Xiaoqun Li
- Orthopedics Department, Qionglai Medical Center Hospital, 611530, PR China
| | - Fangdi Liu
- Orthopedics Department, Qionglai Medical Center Hospital, 611530, PR China
| | - Chunhua Deng
- Orthopedics Department, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, PR China
| | - Ping Jia
- Department of Neurosurgery Intensive Care Unit (NICU), Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, PR China
| | - Yang Yang Liu
- Academic Administration, Qionglai Vocational Education center,611530, PR China
| | - Caixia Xie
- Nursing Department, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, PR China; Medical School, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, PR China.
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Mukund AX, Lu A, Asamoah A, Balakrishnan K. Towards a wraparound model of surgical care: Expanding out-of-hospital phases and integrating health justice considerations to improve health outcomes. Am J Surg 2024; 235:115786. [PMID: 38871551 DOI: 10.1016/j.amjsurg.2024.115786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Affiliation(s)
| | - Amy Lu
- Department of Anesthesiology, University of California-San Francisco School of Medicine, San Francisco, CA, USA
| | - Afia Asamoah
- Co-Founder and Head of People and Legal, Waymark, San Fracisco, California, USA
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Mashhadi-Naser S, Sabet FP, Nasiri M, Vasli P. Benefits of a family-based care transition program for older adults after hip fracture surgery. Aging Clin Exp Res 2024; 36:142. [PMID: 39002096 PMCID: PMC11246294 DOI: 10.1007/s40520-024-02794-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery. METHODS A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05. RESULTS The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support. CONCLUSION Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS.
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Affiliation(s)
- Sahar Mashhadi-Naser
- Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashaei Sabet
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Huang Z, Li Y, Peng J, Wang H, Shen K, Li Y, Yu K. Effects of clinical nursing pathway on the surgical site wound infection in patients undergoing knee or hip replacement surgery: A meta-analysis. Int Wound J 2024; 21:e14657. [PMID: 38472128 PMCID: PMC10932801 DOI: 10.1111/iwj.14657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/22/2023] [Indexed: 03/14/2024] Open
Abstract
To explore the effect of clinical nursing pathway on wound infection in patients undergoing knee or hip replacement surgery. Computerised searches of PubMed, Web of Science, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database, China National Knowledge Infrastructure databases were conducted, from database inception to September 2023, on the randomised controlled trials (RCTs) of application of clinical nursing pathway to patients undergoing knee and hip arthroplasty. Literature was screened and evaluated by two researchers based on inclusion and exclusion criteria, and data were extracted from the final included literature. RevMan 5.4 software was employed for data analysis. Overall, 48 RCTs involving 4139 surgical patients were included, including 2072 and 2067 in the clinical nursing pathway and routine nursing groups, respectively. The results revealed, compared with routine nursing, the use of clinical nursing pathways was effective in reducing the rate of complications (OR = 0.17, 95%CI: 0.14-0.21, p < 0.001) and wound infections (OR = 0.29, 95%CI: 0.16-0.51, p < 0.001), shortens the hospital length of stay (MD = -4.11, 95%CI: -5.40 to -2.83, p < 0.001) and improves wound pain (MD = -1.34, 95%CI: -1.98 to -0.70, p < 0.001); it also improve patient satisfaction (OR = 7.13, 95%CI: 4.69-10.85, p < 0.001). The implementation of clinical nursing pathways in clinical care after knee or hip arthroplasty can effectively reduce the incidence of complications and wound infections, and also improve the wound pain, while also improving treatment satisfaction so that patients can be discharged from the hospital as soon as possible.
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Affiliation(s)
- Zhifeng Huang
- Department of Trauma OrthopedicsChongqing General HospitalChongqingChina
| | - Yuanli Li
- Department of Critical MedicineChongqing General HospitalChongqingChina
| | - Jing Peng
- Department of Trauma OrthopedicsChongqing General HospitalChongqingChina
| | - Hao Wang
- Department of GastroenterologyChongqing General HospitalChongqingChina
| | - Kai Shen
- Department of Spine SurgeryChongqing General HospitalChongqingChina
| | - Ya Li
- Department of Cardiovascular SurgeryChongqing General HospitalChongqingChina
| | - Keping Yu
- Department of NursingChongqing General HospitalChongqingChina
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Crijns TJ, Segina P, Kortlever JTP, Thomas JE, Ring D, Reichel L, Vagner G, Ramtin S. Moderators and Mediators of the Relationship of Shared Decision-Making and Satisfaction. J Patient Exp 2023; 10:23743735231171563. [PMID: 37138951 PMCID: PMC10150427 DOI: 10.1177/23743735231171563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Background:Evidence suggests that health literacy, perceived availability of information and guidance to adapt to challenges (informational support), and symptoms of depression all have the potential to mediate or moderate the relationship between patient-rated involvement in decisions and satisfaction with care. If so these could be useful targets for improving patient experience. Methods: We prospectively enrolled 130 new adult patients visiting an orthopedic surgeon over a 4-month period. All patients were asked to complete measures of satisfaction with care (21-item Medical Interview Satisfaction Scale), perceived involvement in decisions (9-item Shared Decision-Making Questionnaire), symptoms of depression (the Patient-Reported Outcomes Measurement Information Scale [PROMIS] Depression Computerized Adaptive Test [CAT]), perceived availability of information and guidance to adapt to challenges (PROMIS Informational Support CAT), and the Newest Vital Sign test of health literacy. Results: The strong correlation between satisfaction with care (ρ = 0.60, P < .001) and perceived involvement in decisions was neither mediated nor moderated by health literacy, perceived availability of information and guidance, and symptoms of depression. Conclusions: The observation that patient-rated shared decision-making is strongly related to satisfaction with an office visit, independent of health literacy, perceived support, and symptoms of depression, is consistent with evidence that various measures of patient experience tend to correlate and emphasizes the importance of the patient-clinician relationship. Level of Evidence: Level II, prospective study.
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Affiliation(s)
- Tom J Crijns
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
| | - Paxton Segina
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
| | - Joost T P Kortlever
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
| | - Jacob E Thomas
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
| | - David Ring
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
- David Ring, Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Health Discovery Building 6.706; 1701 Trinity St., Austin, TX 78712, USA.
| | - Lee Reichel
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
| | - Gregg Vagner
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
| | - Sina Ramtin
- Department of Surgery and
Perioperative Care, Dell Medical School, The University of Texas at Austin,
Austin, TX, USA
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Galuzinskii O, Chornyi V, Kozik Y, Fedin Y. TOTAL HIP JOINT REPLACEMENT USING A CUSTOM TRIFLANGE ACETABULAR COMPONENT (LITERATURE REVIEW). WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:2694-2699. [PMID: 38290035 DOI: 10.36740/wlek202312120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE The aim: The purpose of the article is to analyze the ways of solving the problem of revision hip joint replacement. The article discusses the methods of treatment using a custom triflange acetabular component. PATIENTS AND METHODS Materials and methods: The analysis of 37 literary sources includes a discussion of the features of the use of individual triflange acetabular components and errors in revision hip arthroplasty, which are associated with various factors. CONCLUSION Conclusions: A review of studies devoted to the use of custom triflange acetabular components confirms the effectiveness in the early postoperative period in the treatment of critical acetabular defects and pelvic ring discontinuity. The CTAC use is particularly relevant in case of the pelvic ring disintegration, as it provides for the appropriate endoprosthesis adaptation with the healthy bone, as well as for the bone defects plastics and recovery of the hip joint biome¬chanics. So, the use of individual constructions is indicated for the patients with significant bone mass loss, where augment adaptation and adjustment is impossible. This method is used more often when there is no other alternative. Research results showed a trend that special three-flange components of the acetabulum have better long-term results compared to traditional standard components for large bone defects. Improving production and increasing the number of CTACs should reduce their cost. In summary, the custom triflange acetabulum components provide a personalized secure fit that can reduce the risk of complications and improve patient outcomes. In summary, the triple-flange acetabulum components provide a personalized secure fit that can reduce the risk of complications and improve patient outcomes.
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Affiliation(s)
- Olexander Galuzinskii
- LLC «OSTEONICA», KYIV, UKRAINE; R.E.KAVETSKY INSTITUTE OF EXPERIMENTAL PATHOLOGY, ONCOLOGY AND RADIOBIOLOGY NAS OF UKRAINE, KYIV, UKRAINE
| | | | - Yevhenii Kozik
- SI "INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF NAMS OF UKRAINE", KYIV, UKRAINE
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Effect of Marital Status on Outcomes Following Total Joint Arthroplasty. Arch Orthop Trauma Surg 2022; 142:3651-3658. [PMID: 34032892 DOI: 10.1007/s00402-021-03914-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The purpose of this study is to investigate whether the specific socioeconomic factor such as marital status has any effect on clinical outcomes and patient-reported outcome measures (PROMs) after primary total hip (THA) and knee (TKA) arthroplasty. MATERIALS AND METHODS We retrospectively reviewed patients who underwent primary THA or TKA from January 2019 to August 2019 who answered all PROM questionnaires. Both THA and TKA patients were separated into two groups based on their marital status at the time of surgery (married vs. non-married). Demographics, clinical data, and PROMs (FJS-12, HOOS, JR, KOOS, JR, and VR-12 PCS&MCS) were collected at various time-periods. Demographic differences were assessed using chi-square and independent sample t tests. Clinical data and mean PROMs were compared using multilinear regressions while accounting for demographic differences. RESULTS This study included 389 patients who underwent primary THA and 193 that underwent primary TKA. In the THA cohort, 256 (66%) patients were married and 133 (34%) were non-married. In the TKA cohort, there were 117 (61%) married patients and 76 (39%) non-married patients. Length of stay was significantly shorter for married patients in both the THA (1.30 vs. 1.64; p = 0.002) and TKA (1.89 vs. 2.36; p = 0.024) cohorts. Surgical-time, all-cause emergency department visits, discharge disposition, and 90-day all-cause adverse events (readmissions/revisions) did not statistically differ between both cohorts. Both HOOS, JR and KOOS, JR score improvements from baseline to 1-year did not statistically differ for the THA and TKA cohorts, respectively. Although VR-12 PCS (p = 0.012) and MCS (p = 0.004) score improvement from baseline to 1-year statistically differed for the THA cohort, they did not for the TKA cohort. CONCLUSION Total joint arthroplasty may yield similar clinical benefits in all patients irrespective of their marital status. Although some PROMs statistically differed among married and non-married patients, the differences are likely not clinically significant. Surgeons should continue to assess levels of psychosocial support in their patients prior to undergoing TJA to optimize outcomes. LEVEL OF EVIDENCE III, Retrospective Cohort Study.
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8
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Haluzynskyi OA, Chornyi VS, Burburska SV, Kozik YV. USE OF COMPUTER NAVIGATION IN TOTAL HIP ARTHROPLASTY (LITERATURE REVIEW). WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1765-1770. [PMID: 35962695 DOI: 10.36740/wlek202207128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim: Analyze the accuracy and ease of use of various computer navigations in total hip arthroplasty. PATIENTS AND METHODS Materials and methods: Data from about 50 literature sources for the last two decades have been analysed. CONCLUSION Conclusions: Analyzing the accuracy and ease of use of various computer navigations in total hip arthroplasty, we offer two the most promising for further study and improvement systems: a semi-active navigation system and augmented reality system in total hip arthroplasty.
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Affiliation(s)
| | | | - Svitlana V Burburska
- SI "INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF NAMS OF UKRAINE", KYIV, UKRAINE
| | - Yevhenii V Kozik
- SI "INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF NAMS OF UKRAINE", KYIV, UKRAINE
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Schultz BJ, Tanner N, Shapiro LM, Segovia NA, Kamal RN, Bishop JA, Gardner MJ. Patient-Reported Outcome Measures (PROMs): Influence of Motor Tasks and Psychosocial Factors on FAAM Scores in Foot and Ankle Trauma Patients. J Foot Ankle Surg 2021; 59:758-762. [PMID: 32173179 DOI: 10.1053/j.jfas.2020.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/27/2020] [Indexed: 02/03/2023]
Abstract
Patient-reported outcome measures (PROMS) are being increasingly used as a quality of care metric. However, the validity and consistency of PROMS remain undefined. The study sought to determine whether Foot and Ankle Ability Measure (FAAM) scores improve after patients complete motor tasks evaluated on the survey and to examine the relationship between depression and self-efficacy and FAAM scores or change in scores. We conducted a prospective comparison study of adults with isolated foot, ankle, or distal tibia fractures treated operatively at level I trauma center. Twenty-seven patients completed the FAAM survey at the first clinic visit after being made weightbearing as tolerated (mean 3 months). Patients then completed 6 motor tasks queried on FAAM (standing, walking without shoes, squatting, stairs, up to toes), followed by a repeat FAAM and General Self-Efficacy scale (GSE) and Patient Health Questionnaire-2 (PHQ-2) instruments. FAAM scores before and after intervention; GSE and PHQ-2 scores compared with baseline FAAM and change in FAAM scores. Performing motor tasks significantly improved postintervention scores for squatting (P = .044) and coming up to toes (P = .012), the 2 most strenuous tasks. No difference was found for the remaining tasks. Higher depression ratings correlated with worse FAAM scores overall (P < .05). Higher self-efficacy ratings correlated with increase in FAAM Sports subscale postintervention (P = .020). FAAM scores are influenced by performing motor tasks. Self-reported depression influences baseline FAAM scores and self-efficacy may influence change in FAAM scores. Context and patient factors (modifiable and nonmodifiable) affect PROM implementation, with implications for clinical care, reimbursement models, and use of quality measure.
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Affiliation(s)
- Blake J Schultz
- (1)Orthopaedic Surgery Residents, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA.
| | - Natalie Tanner
- Research Coordinator, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Lauren M Shapiro
- (1)Orthopaedic Surgery Residents, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Nicole A Segovia
- Research Data Analyst, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Robin N Kamal
- Assistant Professor, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Julius A Bishop
- Associate Professor, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Michael J Gardner
- Professor and Vice Chair, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA; Chief, Orthopaedic Trauma, Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
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Lall AC, Schwarzman GR, Battaglia MR, Chen SL, Maldonado DR, Domb BG. Effect of marital status on patient-reported outcomes following total hip arthroplasty: a matched analysis with minimum 2-year follow-up. Hip Int 2021; 31:362-368. [PMID: 31328566 DOI: 10.1177/1120700019864015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Mental health and patient expectation have been identified as key predictors of recovery following THA; however, there is limited literature examining the effects of social support and marital status on patient-reported outcomes (PROs). METHODS Data were prospectively collected and retrospectively reviewed for patients who underwent THA between July 2008 and January 2016. Patients were included if they underwent primary THA during this period and if they had documented preoperative marital status of married, divorced, or never married. Married patients were group matched to non-married patients (divorced or never married) with similar sex, age, body mass index (BMI), gender distribution, and frequency of surgical approach. RESULTS There were 414 married patients and 98 non-married patients who were eligible and had minimum 2-year follow-up. Mean PROs were significantly worse in the non-married group than the married group for the following measures: modified Harris Hip Score (p = 0.002), Harris Hip Score (p = 0.002), Forgotten Joint Score (p = 0.04), and the physical portions of the Veterans RAND (p = 0.025) and Short Form (p = 0.02) surveys. CONCLUSIONS Our study demonstrated inferior absolute PRO scores at latest follow-up for patients who were non-married compared to married following THA. These results show that while total hip replacement may still yield clinical benefit in all patients, non-married patients may ultimately achieve an inferior functional status, and expectations should be adjusted accordingly. Physicians should assess levels of psychosocial support in their patients prior to undergoing hip arthroplasty in order to optimise results.
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Zhang X, Chen X, Kourkoumelis N, Gao R, Li G, Zhu C. A Social Media-Promoted Educational Community of Joint Replacement Patients Using the WeChat App: Survey Study. JMIR Mhealth Uhealth 2021; 9:e18763. [PMID: 33734094 PMCID: PMC8088850 DOI: 10.2196/18763] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/25/2020] [Accepted: 10/02/2020] [Indexed: 01/27/2023] Open
Abstract
Background Much effort has been made to optimize the results of total hip arthroplasty and total knee arthroplasty. With the rapid growth of social media use, mobile apps, such as WeChat, have been considered for improving outcomes and patient satisfaction after total hip arthroplasty and total knee arthroplasty. Objective We aimed to evaluate the effectiveness of a WeChat-based community as an intervention for overall patient satisfaction. Methods The study was conducted among discharged in-hospital patients who received hip or knee procedures in the First Affiliated Hospital of the University of Science and Technology of China from April 2019 to January 2020. An educational online social community was constructed with the WeChat app. Participants willing to join the community were enrolled in a WeChat group and received 3 months of intervention and follow-up. Those who were not willing to use the account were included in a control group and received routine publicity via telephone, mail, and brochures. The Danish Health and Medicine Authority patient satisfaction questionnaire was used to score perioperative patient education and overall satisfaction. The contents in the group chat were analyzed using natural language processing tools. Results A total of 3428 patients were enrolled in the study, including 2292 in the WeChat group and 1236 in the control group. Participants in the WeChat group had higher overall satisfaction scores than those in the control group (mean 8.48, SD 1.12 vs mean 6.66, SD 1.80, P<.001). The difference between the two groups was significant for primary surgery based on subgroup stratification. To control confounding factors and explore the effects of WeChat participation as a mediating variable between perioperative patient education and overall satisfaction, hierarchical regression was utilized. An interpatient interaction model was found in the community group chat, and it contributed to overall satisfaction. Patients in the group with more interpatient interactions were more likely to have better overall satisfaction. Conclusions The social media–promoted educational community using WeChat was effective among joint replacement patients. Provision of more perioperative education is associated with more active patient participation in the community and therefore more patient satisfaction in terms of the overall joint procedure. Community group chat could facilitate interactions among patients and contribute to overall satisfaction.
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Affiliation(s)
- Xianzuo Zhang
- Department of Orthopedics, The First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiaoxuan Chen
- College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, China
| | - Nikolaos Kourkoumelis
- Department of Medical Physics, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ran Gao
- Department of Applied Psychology, School of Humanities, Guangdong Peizheng College, Guangzhou, China
| | - Guoyuan Li
- Department of Orthopedics, The First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chen Zhu
- Department of Orthopedics, The First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Thacker J, Bosello F, Ridehalgh C. Do behaviour change techniques increase adherence to home exercises in those with upper extremity musculoskeletal disorders? A systematic review. Musculoskeletal Care 2020; 19:340-362. [PMID: 33331093 DOI: 10.1002/msc.1532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To investigate whether behaviour change techniques (BCTs) can influence adherence to home exercise in people with upper extremity musculoskeletal disorders (UEMD). DESIGN A systematic review of randomised control trials, non-randomised control trials, case-control studies and cohort studies. Results were presented narratively. Participants were those with UEMD. The intervention was any home exercise programme, alongside a BCT designed to increase exercise adherence. Any duration of intervention was accepted. The main outcome sought was adherence to home exercise. A systematic search was performed on four online databases. Grey literature was searched. RESULTS The search resulted in 28,755 titles. 77 full-text articles were assessed for eligibility. Six studies were included in the qualitative synthesis. Four studies had Some Concern of Bias, whilst two studies had High Risk of Bias. Three studies found statistically significant differences in exercise adherence (p < 0.05) between the Intervention group and Control group. The BCT 'Social Support (unspecified)' was used within all studies that found significant differences in adherence levels at outcome. However, multiple BCTs were received by the Intervention groups within all studies, making it impossible to identify the effects of any single BCT upon adherence levels. CONCLUSION Social support may be relevant in patients' adherence levels to HEPs. However, confidence in the results is uncertain given the small number of studies found, and their High RoB. Future studies should validate their measurement and definition of adherence, as well as the number of BCTs they use, to provide reproducible evidence.
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Affiliation(s)
| | - Francesca Bosello
- European School of Physiotherapy, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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Saad R, Beydoun M, Fuleihan GEH. Management of Hip Fractures at an Academic Center: Challenges and Opportunities. J Clin Densitom 2020; 23:524-533. [PMID: 30691870 DOI: 10.1016/j.jocd.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/26/2018] [Accepted: 01/02/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess characteristics of patients with hip fractures and investigate the extent of osteoporosis-related care they receive at a tertiary referral center in Lebanon. METHODS A retrospective review of charts of 400 patients admitted with a hip fracture to the American University of Beirut-Medical Center, between January 1, 2011 and December 31, 2015. We reviewed medical records of adults admitted with a nonpathologic/nontraumatic hip fracture, and evaluated basic demographics and relevant clinical information, associated risk factors, and the management received. RESULTS The mean age of the population was 78 ± 10 years and men constituted 37%. Women were more likely to be assessed and/or treated. On admission, 21% were taking calcium and 18% vitamin D supplementation. During hospitalization, vitamin D level was assessed in only 39% of patients; a dietary and an osteoporosis consult were requested on only 32% and 22% of the cases, respectively. One-fourth to a third of patients were discharged on calcium or vitamin D, and less than 5% on bisphosphonates. Bone mineral density was measured in a minority although 21% had a history of previous contralateral hip fracture. One year mortality rate in a subset where follow-up available was 12% in men and 7% in women. CONCLUSION A large care gap in the management of patients admitted with hip fracture persists despite clear national osteoporosis guidelines. This study provides a strong impetus for establishing and monitoring a fracture liaison service to understand and address barriers to providing optimal care to patients with osteoporosis.
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Affiliation(s)
- Randa Saad
- American University of Beirut-Medical Center, Beirut, Lebanon
| | - Maya Beydoun
- American University of Beirut-Medical Center, Beirut, Lebanon
| | - Ghada El-Hajj Fuleihan
- American University of Beirut-Medical Center, Beirut, Lebanon; Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders at the American University of Beirut-Medical Center, Beirut, Lebanon.
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Seasoning Polymethyl Methacrylate (PMMA) Bone Cements with Incorrect Mix Ratio. MATERIALS 2019; 12:ma12193073. [PMID: 31547178 PMCID: PMC6804204 DOI: 10.3390/ma12193073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/03/2019] [Accepted: 09/18/2019] [Indexed: 02/07/2023]
Abstract
Cemented joint prostheses are widely used in orthopaedic surgery; however, implants/bone bonds are known to be susceptible to aseptic loosening, particularly in the case of long-term performance. The exact mechanism of this failure is under constant examination. One of the critical factors to the final mechanical functionality of bone cement can be an incorrect mix ratio of a two-component material (powdered polymer and liquid monomer). It can result in the deterioration of the final mechanical strength properties. The paper presents the results from an experimental study on the effects of the deviation from the correct mix ratio on the moisture uptake and the compression strength of cement depending on the seasoning time in Ringer's solution. The results were subjected to statistical analysis and a mathematical model was developed.
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