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Fu Y, Zhu LJ, Li DC, Yan JL, Zhang HT, Xuan YH, Meng CL, Sun YH. Evidence-based intervention on postoperative fear, compliance, and self-efficacy in elderly patients with hip fracture. World J Clin Cases 2022; 10:3069-3077. [PMID: 35647121 PMCID: PMC9082697 DOI: 10.12998/wjcc.v10.i10.3069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/07/2022] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Elderly patients tend to have poor self-efficacy and poor confidence in postoperative rehabilitation for hip fractures, and are prone to negative emotions, which affect treatment compliance.
AIM To evaluate the effects of evidence-based intervention on postoperative fear, compliance, and self-efficacy in elderly patients with hip fractures.
METHODS A total of 120 patients with hip fracture surgically treated from June 2018 to June 2020 at the orthopedic department of our hospital were selected and divided into intervention and routine groups (n = 60 each) according to different nursing methods. The basic rehabilitation methods of the two groups were consistent, but patients in the intervention group received evidence-based nursing interventions at the same time. Differences between groups in the scores of motion phobia, pain fear, rehabilitation training compliance, self-efficacy, nursing satisfaction, and hip joint function were compared before and after the intervention.
RESULTS Before the intervention, there were no statistically significant differences in motion phobia and pain fear scores between the groups (all P > 0.05). However, motion phobia scores at 1 wk after intervention initiation (P < 0.05), and pain fear scores at 1 wk and 2 wk after intervention initiation (all P < 0.05), were significantly lower in the intervention group than in the routine group. On the first day of intervention, there was no significant difference in rehabilitation treatment compliance between the groups (P > 0.05); however, at 2 wk after intervention initiation, rehabilitation compliance was significantly better in the intervention group than in the routine group (P < 0.05). Before the intervention, there were no statistically significant differences in the scores for the two self-efficacy dimensions (overcoming difficulties and rehabilitation exercise self-efficacy) and the total self-efficacy score between the groups (all P > 0.05). After 2 wk of intervention, the scores for these two dimensions of self-efficacy and the total self-efficacy score were significantly higher in the intervention group than in the routine group (all P < 0.05). At 3 and 6 mo after surgery, hip function as evaluated by the Harris hip score, was significantly better in the intervention group than in the routine group (P < 0.05). Additionally, overall nursing satisfaction was significantly higher in the intervention group than in the routine group (P < 0.05).
CONCLUSION Evidence-based nursing intervention can alleviate fear of postoperative rehabilitation in elderly patients who underwent hip fracture surgery, and improve rehabilitation treatment compliance and patient self-efficacy, which promote hip function recovery.
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Affiliation(s)
- Ying Fu
- Joints Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Li-Juan Zhu
- Traumatic Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Da-Cheng Li
- Traumatic Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Jing-Lei Yan
- Joints Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Hai-Ting Zhang
- Joints Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Yu-Hong Xuan
- Nursing Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Chun-Ling Meng
- Joints Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
| | - Yan-Hong Sun
- Joints Osteopathic Department, Chengde Central Hospital, Chengde 067000, Hebei Province, China
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Allen LL, Uphold CR, Koniaris-Rambaud C, House K, Gray F, Fitzgerald L, Vaughan C, Johnson TM. Palliative care aspects of wound healing in complex patients: a case report. J Wound Care 2021; 30:845-852. [PMID: 34644138 DOI: 10.12968/jowc.2021.30.10.845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
DECLARATION OF INTEREST The authors have no conflicts of interest to declare.
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Affiliation(s)
- Latricia L Allen
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Constance R Uphold
- VA Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, US
| | - Christine Koniaris-Rambaud
- Department of Medicine, Emory University, Atlanta, GA, US.,Department of Family and Preventive Medicine, Emory University, Atlanta, GA, US
| | - Kim House
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Frances Gray
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US
| | - Linda Fitzgerald
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US
| | - Camille Vaughan
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Theodore M Johnson
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US.,Department of Family and Preventive Medicine, Emory University, Atlanta, GA, US
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Armstrong DG, Orgill DP, Galiano RD, Glat PM, Kaufman JP, Carter MJ, Zelen CM. An observational pilot study using a purified reconstituted bilayer matrix to treat non-healing diabetic foot ulcers. Int Wound J 2020; 17:966-973. [PMID: 32266774 PMCID: PMC7384195 DOI: 10.1111/iwj.13353] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 12/18/2022] Open
Abstract
Diabetic foot ulcers (DFUs) have significant clinical impact and carry a substantial economic burden. Patients with DFUs that are refractory to standard wound care are at risk for major complications, including infection and amputation and have an increased risk of mortality. This study evaluated the safety and preliminary efficacy of a novel decellularised purified reconstituted bilayer matrix (PRBM) in treating DFUs. Ten diabetic patients with refractory wounds that failed to heal after at least 4 weeks of standard wound care were studied in this Institutional Review Board approved trial. Ten consecutive wounds were treated weekly with the PRBM for up to 12 weeks. At each weekly visit, the wound was evaluated, photographed, and cleaned, followed by application of new graft if not completely epithelialised. Assessment included measurement of the wound area and inspection of the wound site for signs of complications. The primary outcome measure was wound closure, as adjudicated by independent reviewers. Secondary outcomes included assessment of overall adverse events, time to closure, percent area reduction, and the cost of product(s) used. Nine of 10 patients achieved complete wound closure within 4 weeks, and 1 did not heal completely within 12 weeks. The mean time to heal was 2.7 weeks. The mean wound area reduction at 12 weeks was 99%. No adverse events nor wound complications were observed. These early clinical findings suggest that the PRBM may be an effective tool in the treatment of diabetic foot ulcers.
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Affiliation(s)
- David G Armstrong
- Division of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Dennis P Orgill
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Robert D Galiano
- Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Paul M Glat
- Professor of Surgery and Pediatrics, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA
| | - Jarrod P Kaufman
- Department of Surgery, Temple University School of Medicine and McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Charles M Zelen
- Professional Education and Research Institute, Roanoke, Virginia, USA
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Promoting Limb Salvage through Multi-Disciplinary Care of the Diabetic Patient. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017; 19:55. [PMID: 28567565 DOI: 10.1007/s11936-017-0547-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OPINION STATEMENT Despite an explosion in the number of options available for helping diabetic patients heal wounds, major amputation remains a critical issue for these persons. Since diabetes prematurely ages tissues and no organ system is immune to its presence, it makes inherent sense that multi-disciplinary team approaches to these patients is necessary to make significant strides forward. Here, we present literature from the fields of podiatric surgery/medicine, vascular and plastic surgery and introduce the successes that a multi-disciplinary limb salvage center can have on the lives and limbs of patients with diabetes.
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Nouvong A, Ambrus AM, Zhang ER, Hultman L, Coller HA. Reactive oxygen species and bacterial biofilms in diabetic wound healing. Physiol Genomics 2016; 48:889-896. [PMID: 27764766 DOI: 10.1152/physiolgenomics.00066.2016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Chronic wounds are a common and debilitating complication for the diabetic population. It is challenging to study the development of chronic wounds in human patients; by the time it is clear that a wound is chronic, the early phases of wound healing have passed and can no longer be studied. Because of this limitation, mouse models have been employed to better understand the early phases of chronic wound formation. In the past few years, a series of reports have highlighted the importance of reactive oxygen species and bacterial biofilms in the development of chronic wounds in diabetics. We review these recent findings and discuss mouse models that are being utilized to enhance our understanding of these potentially important contributors to chronic wound formation in diabetic patients.
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Affiliation(s)
- Aksone Nouvong
- Department of Vascular Surgery, David Geffen School of Medicine, Los Angeles, California.,Department of Podiatric Medicine and Surgery, Department of Veteran Affairs of Greater Los Angeles Healthcare System, Los Angeles, California
| | - Aaron M Ambrus
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, California; and.,Department of Biological Chemistry, David Geffen School of Medicine, Los Angeles, California
| | - Ellen R Zhang
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, California; and.,Department of Biological Chemistry, David Geffen School of Medicine, Los Angeles, California
| | - Lucas Hultman
- Department of Podiatric Medicine and Surgery, Department of Veteran Affairs of Greater Los Angeles Healthcare System, Los Angeles, California
| | - Hilary A Coller
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, California; and .,Department of Biological Chemistry, David Geffen School of Medicine, Los Angeles, California
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