The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: a randomized study

Núñez, Montserrat; Núñez, Esther; Segur, J.M.; Maculé, F.; Quinto, Levio; Hernández, M. Victoria; Vilalta, C. Pellicé i

doi:10.1016/j.joca.2005.10.002

Cited by 69 publications

(86 citation statements)

References 28 publications

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“…Educational programs directed towards improving health-related quality of life in patients on the surgical waiting list show promise. However, this does not address the underlying issue of the impact of the actual length of wait as it pertains to physical functioning parameters [15]. Medical expert consensus based criteria tools for prioritizing patients on the waiting list for surgery may facilitate a more broad based specialty equity in the access to surgical treatment [5].…”

Section: Discussionmentioning

confidence: 99%

The impact of surgical wait time on patient-based outcomes in posterior lumbar spinal surgery

et al. 2007

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A prospective observational study was conducted on patients undergoing posterior lumbar spine surgery for degenerative spinal disorders. The study purpose was to evaluate the effect of wait time to surgery on patient derived generic and disease specific functional outcome following surgery. A prolonged wait to surgery may adversely affect surgical outcome. Although there is literature on the effect of wait time to surgery in surgical fields such as oncology, cardiac, opthamologic, and total joint arthroplasty, little is known regarding the effect of wait time to surgery as it pertains to the spinal surgical population. Consecutive patients undergoing elective posterior lumbar spinal surgery for degenerative disorders were recruited. Short-Form 36 and Oswestry disability questionnaires were administered (pre-operatively, and at 6 weeks, 6 months, and 1 year post-operatively). Patients completed a questionnaire regarding their experience with the wait time to surgery. The study cohort consisted of 70 patients with follow-up in 53/70 (76%). Time intervals from the onset of patient symptoms to initial consultation by family physician through investigations, spinal surgical consultation and surgery were quantified. Time intervals were compared to patient specific improvements in reported outcome following surgery using Cox Regression analysis. The effect of patient and surgical parameters on wait time was evaluated using the median time as a reference for those patients who had either a longer or shorter wait. Significant improvements in patient derived outcome were observed comparing post-operative to pre-operative baseline scores. The greatest improvements were observed in aspects relating to physical function and pain. A longer wait to surgery was associated with less improvement in outcome following surgery (SF-36 domains of BP, GH, RP, VT). A longer wait time to surgery negatively influences the results of posterior lumbar spinal surgery for degenerative conditions as quantified by patient derived functional outcome measures. The parameters of pain severity and physical aspects of function appear to be the most significantly affected.

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Section: Discussionmentioning

confidence: 99%

The impact of surgical wait time on patient-based outcomes in posterior lumbar spinal surgery

et al. 2007

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“…In previous studies, attempts were made to standardize protocols and define variables according to their possible influence on TKA outcomes [24,25]. Additionally, the patient's perspective was incorporated in the evaluation of outcomes using HRQL measures [23,24].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, the patient's perspective was incorporated in the evaluation of outcomes using HRQL measures [23,24]. Disease-specific instruments focus on issues related to a particular health condition and can be used in therapeutic management [22].…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Health-related Quality of Life after TKA in Patients who are Obese

Núñez

Lozano

Núñez

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Although the health-related quality of life (HRQL) for patients who are obese seems to improve after TKA, the magnitude of improvement and the associated factors remain controversial. We previously found body mass index was not associated with changes in HRQL after TKA. Questions/purposes The purposes of this secondary analysis were to determine which patient characteristics and surgical factors were associated with worse health status after TKA in patients who are severe or morbidly obese. Methods We assessed 60 patients (53 females; mean age, 70 years) 12 months after surgery. The mean number of comorbidities was 2.5. Mean lower limb anthropometric index scores were: suprapatellar, 1.6; infrapatellar, 2; and suprapatellar/infrapatellar, 1.2. Intraoperative difficulty (IOD) was Grade 0, 40%; Grade 1, 48%; and Grade 2, 12%. Ten patients (17%) had complications. We measured HRQL using the disease-specific WOMAC questionnaire. Patient characteristics (sociodemographic variables, BMI, comorbidity, lower limb anthropometry) and surgical factors (IOD, complications, postoperative medical data) were collected. Associations between WOMAC dimension scores at 12 months and patient characteristics and surgical factors were analyzed using linear regression models. Results Factors associated with worse WOMAC dimension scores in patients who were obese included the number of comorbidities, an infrapatellar index percentile less than 75, IOD Grade 2, and the number of complications after discharge. Conclusions For patients with knee osteoarthritis who were severe or morbidly obese, various lower limb anthropometric features, degree of IOD, and postoperative complications negatively influenced postoperative WOMAC scores. Level of EvidenceLevel II Prognostic Study. See Guidelines for a complete description of levels of evidence.

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“…Este estudio se centra en el empowerment o empoderamiento de los pacientes con OA durante el proceso quirúrgico de ATC y ATR, mediante actividades de información-educación. Se han escogido estas cirugías ya que influyen de manera notable en las actividades de la vida diaria de los pacientes y de sus familias, 27,28,29,30,31,32 y pueden ser apoyadas con información-educación de los pacientes. En el sistema nacional de salud, la demanda de tales intervenciones supera ampliamente la oferta, lo que da lugar a largas listas de espera.…”

Section: Artroplastia De Rodillaunclassified

“…Este estudio forma parte de un proyecto europeo sobre educación empoderadora en pacientes con osteoartritis en un contexto quirúrgico (32). El objetivo del actual estudio fue evaluar la validez y la fiabilidad de la versión española de la doble escala ECPH/CRPH en pacientes con OA operados de Artroplastia Total de Rodilla (ATR).…”

Section: Introductionunclassified

Empoderamiento del paciente con osteoartritis

Plans¹

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Este largo periodo de tiempo que he dedicado a este proyecto, debo destacar que no ha sido un camino en solitario, cuento con el apoyo de algunas personas que me han brindado la oportunidad de llegar hasta aquí, a pesar de los momentos difíciles.Para empezar, debo agradecer de manera muy especial y sincera a mi tutora, la Dra. Adelaida Zabalegui, el hecho de darme la posibilidad de participar en este proyecto tan ambicioso y enriquecedor bajo su dirección, que me ha permitido un crecimiento tanto personal como profesional transmitiéndome su apoyo y confianza en mi trabajo, su capacidad para guiar constantemente mis ideas y toda la ayuda necesaria para tirar adelante este proyecto.También quiero agradecer a mi codirectora, Dra. Esther Cabrera, por creer en el crecimiento profesional de las enfermeras en nuestra disciplina.Este proyecto ha requerido la colaboración de varios miembros de investigación de diver- Mi más sincero agradecimiento a todos los participantes en este estudio a escala nacional: Bárbara Amor, Cristina Moreno, Olga Monistrol, Teresa Camps, José Manuel Verge, Elisabeth Argemí, Núria Sapena y Agnès Nicolau. Gracias por formar parte del proyecto y creer que se puede llevar a cabo. Hace que todos los sacrificios merezcan la pena.A mi compañera y amiga, Laia, por todas las horas dedicadas a este proyecto. Por su entusiasmo por la profesión y por estar siempre a mi lado.A Pablo, por su ayuda ofrecida y a mi primo, Esteve, por su gran apoyo y aportación a este proyecto.Y, por último, a mis amigos: gracias por darme apoyo en este reto académico y por aceptar mis ausencias todo este tiempo.Y sobre todo... A mis padres, Asun y Eduardo, por creer en mí y ofrecerme todo su apoyo incondicional.A mi hermana, Vaniah, por estar conmigo en todo momento, y a mi abuela, Llorença por toda su paciencia y comprensión. Este estudio de investigación forma parte de un proyecto internacional, con el objetivo de establecer las bases teóricas del empoderamiento y el modelo de una educación empoderadora del paciente (EEP).El empowerment o empoderamiento se refiere, principalmente, a la capacidad del individuo para tomar decisiones y ejercer control sobre su vida personal. Cuando una persona se encuentra en un proceso de pérdida de salud, generalmente tiene un desconocimiento del problema de salud y de su gestión. El empoderamiento del paciente es un proceso que integra seis dimensiones de conocimiento: biofisiológica, funcional, social, ética, experiencial y financiera, y su principal premisa es que el paciente debe tener cubiertas todas sus expectativas de información/conocimiento para poder empoderarse.La educación del paciente por parte del profesional de enfermería es un elemento esencial en el proceso del empoderamiento del paciente. Este rol facilitador ha demostrado ser efectivo en pacientes con patologías crónicas, pero existe un vacío en pacientes con procesos agudos -como son las intervenciones quirúrgicas-.La osteoartritis (OA) es una enfermedad degenerativa que comporta dolor, fatiga, inflamación y pérdida de l...

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The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: a randomized study

Cited by 69 publications

References 28 publications

The impact of surgical wait time on patient-based outcomes in posterior lumbar spinal surgery

The impact of surgical wait time on patient-based outcomes in posterior lumbar spinal surgery

Factors Influencing Health-related Quality of Life after TKA in Patients who are Obese

Empoderamiento del paciente con osteoartritis

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