• Title/Summary/Keyword: TKRA

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The Effect of Pre-Operative Patient Controlled Analgesia Education on Elderly Patients with Total Knee Arthroplasty (슬관절 전치술 노인 환자의 수술 전 자가통증조절기 사용 교육이 수술 후 환자에게 미치는 효과)

  • Shim, Joohee;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.318-325
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    • 2014
  • Purpose: The purpose of this study was to investigate the effects of preoperative patient controlled analgesia (PCA) education on total knee replacement arthroplasty (TKRA) patients' PCA usage, level of pain, the frequency of pro re nata (prn) administrations, number of ambulations/day and continuous passive motion (CPM) angle after TKRA. Methods: This research used the non-equivalent control group pre-test and post-test design. Forty-five TKRA patients at a hospital in Seoul, Korea were included for in the study. For the experimental group, a 20-minute education session was provided a day before surgery. Data were analyzed using Windows SPSS Statistics 21.0 program. Results: Knowledge was higher in the experimental group than in the control group (p<.001). Incidence of nausea was lower in the experimental group (p=.01). No significant differences were found in post-operative pain scores, the frequency of prn analgesics administrations, dizziness, number of ambulations/day and CPM angle. Conclusion: This study showed that pre-operative PCA education could be an effective nursing intervention for increasing patient knowledge on PCA and nausea reduction after TKRA.

The Effects of a Progressive Lower-extremity Exercise Program on Pain, Self-efficacy of Exercise, and Life Satisfaction among Older Women with Total Knee Replacement Arthroplasty (TKRA) (슬관절 전치환술 후 점진적 하지운동요법이 통증, 운동자기효능감, 삶의 만족도에 미치는 효과)

  • Yang, Gui Suck;Eun, Young;Moon, Gyung Hee;Lee, Sun Kyung
    • Journal of muscle and joint health
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    • v.21 no.3
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    • pp.215-223
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    • 2014
  • Purpose: The purpose of this study was to examine the effect of a progressive lower-extremity exercise program on pain, efficacy of exercise, and the life satisfaction among older women with TKRA. Methods: This study was a nonequivalent control group non synchronized design and was conducted from 12 September 2012 to 05 February 2014 in G-university hospital located in J-city. The sample was composed of an experimental group (n=20) and a control group (n=20). The progressive lower extremity exercise program was applied to the experimental group for 13 days. NRS scale was used to measure the pain, self-efficacy of exercise was measured by Exercise Self Efficacy, and life satisfaction was measured by 8 item questionnaire. Results: The experimental group was significantly lower in the degree of pain (F=73.53, p<.001), higher in the degree of self-efficacy of exercise (F=61.42, p<.001) and life satisfaction (F=80.91, p<.001) than the control group. Conclusion: The progressive lower-extremity exercise program for TKRA patients was useful to reduce pain and improve self-efficacy of exercise and life satisfaction, To reduce the pain and th improve the life satisfaction of older women with TKRA, we need to provide the progressive exercise at bedside during the postoperative recovery phase.

Evaluation of image quality for metal artifact using protocol parameters in the MRI (자기공명영상에서 프로토콜 변화를 이용한 금속인공물의 영상평가)

  • Lee, Su-Hyun;Kim, Do-Gyoung;Kim, Yo-Han;Yeum, Hyei-Jeong;Lee, Heon-Jun;Lim, Ju-Yeon;Choi, Woo-Jeon;Kim, Dong-hyun
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2015.10a
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    • pp.582-585
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    • 2015
  • In the aging society, TKRA is steadily increased because of joint diseases. Artificial joint used in TKRA generates metal artifacts in the MRI. Metal artifact may affect diagnosis. In study, We are going to minimize the effect of metal artifact to improve the value of diagnosis by changing the sequence and the type of artificial joint(Co-Cr, Ni-Ti). 1.5T AVANTO, plastic containers and each of the artificial joint (Normal, Co-Cr, NiTi) were used. After the artificial joints fixed in a paper cup was inserted in a plastic container of cylindrical, Signal intensity was measured. To obtain strong and uniform signal intensity, the plastic container was filled with water. We changed Sequences(T1 TSE, T2 TSE, PD TSE) and obtained an Axial image. After excepting the maximum and minimum values, We calculated the average of SNR, CNR and PSNR. Consequently, The SNR, CNR value of PD TSE are measured higher than these of T1 TSE, T2 TSE and The PSNR of Co-Cr is higher than this of Ni-Ti. The SNR of Co-Cr is similar to the SNR of normal comparing this of Ni-Ti. As a result, Using sequence of PD Tse and Co-Cr alloy is considered to be useful.

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Effects of the Nei-Guan (P6) Acupressure on Nausea, Vomiting, and Pain in Geriatric Patients after Total Knee Replacement Arthroplasty (내관지압이 슬관절 전치환술 받은 노인 환자의 오심, 구토 및 통증에 미치는 효과)

  • Yoo, Je-Bog;Jang, Hee-Jung;Na, Eun-Hee;Kim, Sun-Young;Shin, Dong-Soo
    • Journal of East-West Nursing Research
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    • v.17 no.2
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    • pp.96-102
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    • 2011
  • Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

Effects of Defecation Encouragement Program in Patients Undergoing total Knee Replacement Arthroplasty (배변 격려 프로그램이 인공 슬관절 전치환술 환자의 배변에 미치는 효과)

  • Park, Jeong Hee;Cheon, Sung Joo;Gwon, Yeong Hee;Park, Hyeon Suk;Kim, Mi Na;Park, Mi Ran;Choi, Hye Jin
    • Journal of muscle and joint health
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    • v.29 no.2
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    • pp.81-90
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    • 2022
  • Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.

Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty (슬관절 전치환술 환자의 저체온 관리를 위한 ASPAN의 근거기반 임상실무 가이드라인 적용 효과)

  • Yoo, Je Bog;Park, Hyun Ju;Chae, Ji Yeoun;Lee, Eun Ju;Shin, Yoo Jung;Ko, Justin Sangwook;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.352-360
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    • 2013
  • Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.