Dissertation/Thesis Abstract

The relationship between patient trust of nursing staff, postoperative pain, and discharge functional outcomes following a total knee arthroplasty
by Burge Bowren, Donna Mechelle, Ph.D., University of Arkansas for Medical Sciences, 2008, 83; 3340139
Abstract (Summary)

One of the most common operative procedures undergone by an older adult is a total knee arthroplasty which is performed to reduce difficulty walking and performing activities of daily living. A fear of poorly controlled pain may discourage an individual from having a total knee arthroplasty, and unrelieved pain during hospitalization may result in failure to meet desired discharge functional outcomes and a prolonged length of stay. Nursing management of patient pain is a key component of postoperative patient care. Patient trust of the nursing staff may affect postoperative pain. However, the relationship between patient trust of nursing staff and pain has not been studied. Thus, the aims of this study were to describe patient trust of nursing staff and describe the relationships among patient trust of nursing staff, postoperative pain, and discharge functional outcomes in patients undergoing total knee arthroplasty.

The study utilized a correlational study design. Study setting was an acute care, private, not-for-profit hospital. Participants completed the Trust Subscale of the Patient's Opinion of Nursing Care to assess trust of nursing staff. Numeric Analog Scale (NAS) measured level of pain. Functional outcome was obtained from knee flexion gain scores. Descriptive statistics were used to describe the sample. Correlation statistics, independent two-sample t-test, and linear regression were utilized to achieve study aims.

Sixty-eight elders participated with a mean age of 66.4 years. The majority of the participants were female (79.4%) and Caucasian (100%). Average NAS pain score was 5.0. Average gain score was 26.8.

Average trust score was 47.5, indicating a higher level of trust. There was no statistically significant association between trust and pain (rho = -0.116, p = 0.347), between trust and functional outcome (rho = 0.073, p = 0.552) and between pain and functional outcome (rho = 0.055, p = 0.657). In the regression model with age, gender and the number of hospitalizations as predictors, the number of hospitalizations was the only significant predictor of trust (p=0.04). As the number of hospitalizations increased, patient trust of the nursing staff decreased. Finally, trust and pain were not predictors of functional outcome in the regression model controlling for age and sex.

This study suggests patients undergoing total knee arthroplasty may benefit from discussing with nursing staff to identify issues from prior hospital experiences. This discussion can identify potential problems which could occur following the total knee arthroplasty. Nursing interventions can be designed to build trust between patient and nursing staff to improve the hospital experience.

Indexing (document details)
Advisor: Tsai, Pao-Feng
School: University of Arkansas for Medical Sciences
School Location: United States -- Arkansas
Source: DAI-B 69/12, Dissertation Abstracts International
Subjects: Medicine, Nursing
Keywords: Nursing staff, Patient trust, Postoperative pain, Total knee arthroplasty
Publication Number: 3340139
ISBN: 978-0-549-94382-2
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