All patients who had three or more major joints (hips or knees) replaced were identified from operation records at one hospital and reviewed to assess outcome. Forty-three were found to suffer from rheumatoid arthritis, four from osteoarthritis and three from psoriatic arthritis. Eight patients had died an average of 2.6 years (range 1-7 years) after their last operation and this was higher than expected, even for RA. Average follow-up in the 36 surviving RA sufferers was 1.8 years, with a minimum of 6 months since last operation. Range of joint movement, pain relief, satisfaction, mobility, disability and social outcomes were assessed and are reported. Patients were satisfied with outcome because of pain relief and functional improvement. No patient required permanent in-patient care, although they still represented a very disabled group with mean HAQ score of 2.75.
EinführungDie Bedarfsmedikation wird von Pflegekräften in Abhängigkeit von der Situation bzw. bei Bedarf verabreicht. Hierbei muss entschieden werden, welches Mittel in welcher Situation und wie häufig verabreicht werden soll. Es wird u. a. häufig in psychiatrischen Einrichtungen, Einrichtungen der Altenpflege sowie auf Stationen der inneren und chirurgischen Medizin verabreicht. Schätzungsweise werden 50 % aller Psychopharmaka (Medikamente mit Einfluss auf die psychische Verfassung, wie z. B. Neuroleptika und Antidepressiva) als Bedarfsmedikation verordnet [4]. Sie werden häufig bei in sich zurückgezogenen psychiatrischen Patienten verordnet. Laut einer Studie haben bis zu 91 % der in sich zurückgezogenen Patienten irgendwann in ihrem Stadium der Zurückgezogenheit eine Bedarfsmedikation erhalten [12]. Die Auswertung vorhandener Daten hat ergeben, dass ca.
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