Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty

Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty

The purpose of this study was to compare pain and anxiety in orthopaedic patients scheduled for elective total hip or knee arthroplasty who have received a kit of nonpharmacologic strategies for pain and anxiety in addition to their regularly prescribed analgesics to those who receive the usual phar...

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Bibliographic Details
Published in:Orthopaedic nursing Vol. 24; no. 3; pp. 182 - 190
Main Authors: Pellino, Teresa A, Gordon, Debra B, Engelke, Zeena K, Busse, Kjersten L, Collins, Mary A, Silver, Catherine E, Norcross, Nancy J
Format: Journal Article
Language:English
Published: United States Lippincott Williams & Wilkins Ovid Technologies 01-05-2005
Subjects:
Adaptation, Psychological
Anxiety
Anxiety - diagnosis
Anxiety - etiology
Anxiety - prevention & control
Anxiety - psychology
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Chi-Square Distribution
Clinical outcomes
Female
Humans
Imagery (Psychotherapy) - education
Imagery (Psychotherapy) - methods
Joint surgery
Male
Massage - education
Massage - methods
Middle Aged
Music Therapy - education
Music Therapy - methods
Nursing
Nursing Assessment
Nursing Audit
Nursing Evaluation Research
Orthopedics
Pain management
Pain Measurement
Pain, Postoperative - diagnosis
Pain, Postoperative - etiology
Pain, Postoperative - prevention & control
Pain, Postoperative - psychology
Patient Education as Topic - methods
Patients
Regression Analysis
Relaxation Therapy - education
Relaxation Therapy - standards
Self Care - methods
Severity of Illness Index
Treatment Outcome
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Summary:The purpose of this study was to compare pain and anxiety in orthopaedic patients scheduled for elective total hip or knee arthroplasty who have received a kit of nonpharmacologic strategies for pain and anxiety in addition to their regularly prescribed analgesics to those who receive the usual pharmacologic management alone. Descriptive comparative and correlational design using surveys and chart audits. Sixty-five patients randomized to receive usual care or usual care plus a kit of nonpharmacologic strategies. Patients who received the kit used nonpharmacologic measures for pain and anxiety more often than patients who did not receive the kit. The kit group tended to use less opioid and have less anxiety on postoperative day 1 (not statistically significant) and use significantly less opioid on postoperative day 2 than the patients who did not receive the kit. There were no between-group differences in pain intensity. There were significant correlations among postoperative pain intensity, opioid use, and anxiety. The coping method of diverting attention was related to lower present (now) pain scores, and ignoring the pain was associated with higher worst pain. Providing a kit of nonpharmacologic strategies can increase the use of these methods for postoperative pain and anxiety and decrease the amount of opioid taken. The influence of coping strategies in acute postoperative pain needs to be examined further.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-News-3
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ISSN:0744-6020
1542-538X
DOI:10.1097/00006416-200505000-00005