Turkiye Klinikleri Journal of Nursing Sciences

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Total Diz Protezi Ameliyatı Olan Hastalarda Kırılganlık Düzeyinin Hasta Öğretimi Müdahalesine Göre Değerlendirilmesi: Paralel Grup Randomize Kontrollü Çalışma
Evaluation of the Level of Fragility in Patients with Total Knee Arthroplasty Surgery According to Patient Training Intervention: Parallel Group, Randomized Controlled Trial
Nilgün ÖZBAŞa, Ahmet ACARb
aYozgat Bozok Üniversitesi Akdağmadeni Sağlık Yüksekokulu, Yozgat, Türkiye
bSağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji ABD, Ankara, Türkiye
Turkiye Klinikleri J Nurs Sci. 2023;15(4):922-30
doi: 10.5336/nurses.2023-98678
Article Language: TR
Full Text
ÖZET
 Amaç: Kırılganlık daha çok ileri yaştaki bireylerde görülen biyolojik, psikolojik ve sosyal alanlarda azalan rezerv ve stres faktörlerine karşı azalan dirençle karakterize olan bir durumdur. Kırılganlık aynı zamanda total diz protezi (TDP) ameliyatı olan bireyler için perioperatif süreçte ciddi risk faktörü olarak görülmektedir. Çalışma TDP ameliyatı olan hastalarda kırılganlık düzeyinin hasta öğretimi müdahalesine göre değerlendirilmesi amacı ile planlanmıştır. Gereç ve Yöntemler: Bu paralel grup randomize kontrollü çalışmada, toplam 110 hasta müdahale (n=55) ve kontrol (n=55) gruplarına rastgele atanmıştır. Müdahale grubu hastalarına, hasta öğretimi müdahalesi yapılmıştır. Veriler hasta tanıtım formu, Edminton Kırılganlık Ölçeği (EKÖ) ve memnuniyet düzeyi için görsel analog skalası kullanılarak toplanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, bağımsız örneklerde t-testi, iki yönlü varyans analizi, Spearman korelasyon analizi, ki-kare testleri, Mann-Whitney U testi ve Bonferroni düzeltmesi kullanılmıştır. Bulgular: Müdahale grubunun EKÖ puanlarının zamanla istatistiksel olarak düştüğü belirlenmiştir (F=112,239; p<0,001). Öğretim sonrası müdahale grubunun EKÖ puanlarının kontrol grubuna göre istatistiksel olarak daha düşük olduğu saptanmıştır (F=39,443; p<0,001). Müdahale grubunun hasta öğretimi memnuniyet puanlarının kontrol grubundan istatistiksel olarak yüksek olduğu belirlenmiştir (p<0,001). Katılımcıların EKÖ puanları ile hasta öğretimi memnuniyet puanları arasında istatistiksel olarak önemli negatif iyi bir ilişki saptanmıştır (rho=-0,670; p<0,001). Sonuç: Sonuçlar hasta öğretiminin kırılganlık düzeyini olumlu etkilediğini ve azalttığını göstermiştir. Bu bağlamda hemşirelerin normal bireylere göre daha fazla risk altında bulunan kırılgan TDP'li bireyleri saptamalarının ve etkili hasta öğretimi planlamalarının, bireylerin bilgi düzeylerini ve farkındalıklarını artırarak kırılganlık yönetimine katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler: Kırılganlık; artroplasti; öğretme; hemşirelik
ABSTRACT
 Objective: Fragility is a condition that characterized by a decreased reserve in biological, psychological and social areas and a decreased resistance to stress factors, which is mostly seen in older individuals. Fragility is also seen as a serious risk factor in the perioperative process for individuals who have had total knee arthroplasty (TKA) surgery. The study was planned with the aim of evaluating the level of fragility in patients undergoing TKA surgery according to the patient teaching intervention. Material and Methods: In this parallel group randomized controlled trial, a total of 110 patients were randomly assigned to the intervention (n=55) and control (n=55) groups. Intervention group patients were exposed to patient teaching intervention. The data were collected by using the patient presentation form, the Edminton Fragility Scale (EFS) and the visual analog scale for satisfaction level. Descriptive statistics, independent samples t test, two-way analysis of variance, Spearman correlation analysis, Chi-square tests, Mann-Whitney U test and Bonferroni correction were used in the evaluation of the data. Results: It was determined that the EFS scores of the intervention group decreased statistically over time (F=112.239; p<0.001). It was found that the EFS scores of the intervention group after teaching were statistically lower than the control group (F=39.443; p<0.001). It was determined that the patient teaching satisfaction scores of the intervention group were statistically higher than the control group (p<0.001). A negative good statistically significant relationship was found between EFS scores of the participants and patient teaching satisfaction scores (rho=-0.670; p<0.001). Conclusion: The results showed that patient teaching positively affects and reduces the level of fragility. In this context, it is thought that nurses' Identification of fragile TKA individuals who are at greater risk than normal individuals and their effective patient teaching planning will contribute to fragility management by increasing the knowledge levels and awareness of individuals.

Keywords: Frailty; arthroplasty; teaching; nursing
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