Sažetak | Među najčešćim razlozima za elektivni ortopedski kirurški zahvat su kronična bol, ograničena pokretljivost ili nemogućnost provođenja aktivnosti svakodnevnog života. Starija populacija odlučuje se za kirurški zahvat radi kronične boli te degenerativnih progresivnih artrotskih promjena u najopterećenijim zglobovima kao što su kuk, koljeno ili rame. U mlađoj i fizički znatno aktivnijoj populaciji razlozi za kirurški zahvat su poteškoće s hrskavičnim oštećenjima, mišićnim sustavom, tetivama i ligamentima, a do kojih dolazi preopterećenjem istih. Posve normalna reakcija pacijenta koja planira odlazak na kirurški zahvat je strah. Razina predoperativnog straha uvelike ovisi o sposobnosti razumijevanja trenutnog stanja, njegovom prihvaćanju, dobi, spolu, osobnosti, samopercepciji i naravno okolini u kojoj se pacijent nalazi. U ovom radu ispitali smo povezanost demografskih značajki s razinom straha prije elektivnog kirurškog zahvata i s postoperativnim tijekom. Također smo ispitali povezanost samoprocijenjene boli i postoperativnog tijeka u ortopedskih pacijenata.
Ispitanici i metode: Istraživanje je uključilo 200 pacijenata kojima je indiciran ortopedski kirurški zahvat. Kirurški zahvati su razvrstani u tri kategorije; manji, srednji i veliki. U istraživanju je korišten strukturirani anketni upitnik koji je podijeljen pacijentima dan prije kirurškog zahvata. Prikupljeni su podaci o sociodemografskim značajkama (spol, dob, mjesto stanovanja, stručna sprema, broj osoba u kućanstvu, bračni i radni status, podatak o ranijim kirurškim zahvatima, ranijim komplikacijama liječenja, pridruženim bolestima, primjeni anksiolitika/sedativa), razini zadovoljstva dosadašnjim zdravljem pomoću Likertove ljestvice te intenzitetu boli pomoću numeričke ljestvice boli. Istraživanje je provedeno na odjelu ortopedije KB „Sveti Duh“ u razdoblju od prosinca 2018. do ožujka 2019. godine. U postoperativnom tijeku praćeno je trajanje hospitalizacije, dan samostalnog ustajanja iz kreveta nakon kirurškog zahvata, te pojava eventualnih postoperativnih komplikacija. Rezultati: Razina straha značajno je viša kod žena nego kod muškaraca, a ispitanici koji su iskazali veću bol ujedno su i kompromitiranijeg zdravstvenog stanja. Također, ispitanici s prijašnjim kirurškim zahvatom ostvarili su duže trajanje hospitalizacije te im je bilo potrebno duže vrijeme da samostalno ustanu iz kreveta nakon kirurškog zahvata. Kod manjih kirurških zahvata veći intenzitet boli bio je povezan s dužom hospitalizacijom dok je kod srednjih kirurških zahvata veći intenzitet boli bio povezan s ranijim samostalnim ustajanjem iz kreveta. Razina predoperativnog straha nije bila povezana s mjestom stanovanja, bračnim i radnim statusom, brojem osoba u kućanstvu, pridruženim bolestima, primjenom anksiolitika, težinom zahvata, komplikacijama te ishodom liječenja.
Zaključak: Ukupna prosječna razina straha kod ispitanika nije značajno povezana s promatranim demografskim značajkama, osim sa spolom. Postoji povezanost intenziteta boli s lošijim zdravstvenim stanjem pacijenta, s trajanjem hospitalizacije i danom samostalnog ustajanja iz kreveta nakon kirurškog zahvata u pojedinim skupinama s obzirom na težinu zahvata. |
Sažetak (engleski) | Among the most common reasons for elective orthopedic surgery are reaching the upper limit of pain tolerance, limited mobility or inability to perform the usual physical activity. The older population chooses surgery after suffering a chronic pain for a long time due to degenerative progressive arthritic changes in the area of largest and at the same time most stressed joints such as hips, knees and shoulders. The young, physically significantly more active population has problems with cartilage damage, the system of muscles, tendons, ligaments and consequently their overloading. The normal reaction of a person planning to undergo such surgery is fear. The level of preoperative fear largely depends on the ability to understand their current status, its acceptance, age, gender, personality, self-perception and, of course, the environment in which the patient lives. In this study we examined the association of demographic characteristics with the level of fear before elective surgery and with the postoperative course. We also examined the association of self-reported pain and postoperative course in orthopedic patients The aim of the study is to investigate whether there is na association between level of fear before elective surgery and the postoperative course, and whether there is an association between pain and the postoperative course, taking into account the patient's socio-demographic characteristics. We will also examine whether there is na association between average pain score and preoperative level of fear.
Respondents and Methods: The survey used a structured questionnaire that was distributed to patients the day before their surgery. Data on sociodemographic characteristics (gender, age, place of residence, education, number of people in the household, marital and working status, data on previous surgical procedures, previous treatment complications, associated diseases, use of anxiolytics / sedatives); the level of satisfaction with current health on a scale from 1 (very dissatisfied) to 5 (very satisfied) and the level of self-reported pain on the visual analogue pain scale was collected. The study was performed at the Orthopedics Department of „KB Sveti Duh“, from December 2018. to March 2019. The postoperative course included the duration of hospitalization, the day of getting out of bed after surgery, and the occurrence of possible postoperative complications. Results: By seeing average results we see that the level of fear is significantly higher in women than in men. Respondents who show greater pain are also more compromised in health. Those who have had earlier surgery have had longer time to get out of bed on their own with longer hospitalization. For small operations, higher pain levels resulted in longer hospitalization, while in medium-demanding operations, greater pain resulted with earlier getting out of bed independently. The level of preoperative fear had no correlation with the
variables place of residence, marriage and working status, number of persons in the household, associated diseases, application of anxiolytics, severity of intervention, complications and outcome of treatment.
Conclusion. We can conclude that the overall average level of fear in the subjects was not significantly related to the observed demographic features. There is a correlation between pain and poorer patient health, and a correlation between pain and length of hospitalization and the day getting out of bed independently after surgery in certain groups considering the severity of the procedure. |