Het effect van preoperatieve informatie op het postoperatief herstel bij het plaatsen van een totale heupprothese

Katrien Vermeulen
Gezien mijn interesse voor orthopedie heb ik ervoor gekozen om mijn eindwerkstage van het derde jaar verpleegkunde te lopen op de afdeling orthopedie van het A.Z. Sint-Lucas te Gent. Men stelde zich de vraag op de afdeling wat de effectiviteit was van het recent ingevoerde “klinisch pad totale heupprothese”. Omwille van een steeds grotere vraag naar patiënteneducatie in de moderne maatschappij is men in dat kader gestart met het geven van preoperatieve informatiesessies en heeft men twee patiëntenbrochures ontwikkeld.

Het effect van preoperatieve informatie op het postoperatief herstel bij het plaatsen van een totale heupprothese

Gezien mijn interesse voor orthopedie heb ik ervoor gekozen om mijn eindwerkstage van het derde jaar verpleegkunde te lopen op de afdeling orthopedie van het A.Z. Sint-Lucas te Gent. Men stelde zich de vraag op de afdeling wat de effectiviteit was van het recent ingevoerde “klinisch pad totale heupprothese”. Omwille van een steeds grotere vraag naar patiënteneducatie in de moderne maatschappij is men in dat kader gestart met het geven van preoperatieve informatiesessies en heeft men twee patiëntenbrochures ontwikkeld. Deze informatieverstrekking vormt, samen met het dossier “klinisch pad totale heup”, de basis van “het klinisch pad totale heupprothese”. Het personeel van de afdeling had het gevoel dat door deze informatie de patiënten minder angstig zijn, minder pijn ervaren, beter revalideren, een hogere tevredenheid ervaren en sneller het ziekenhuis kunnen verlaten. Omdat dit slechts subjectieve ervaringen zijn, heeft men mij gevraagd om hiernaar een klein onderzoek te doen. Mijn eindwerk handelt over het onderzoek dat ik heb gevoerd met de daarbij horende literatuurstudie.

Het opzet van mijn onderzoek was dus om het effect na te gaan van de preoperatieve informatie op het postoperatief herstel bij patiënten met een totale heupprothese. Aan dit onderzoek namen 16 patiënten deel, die een totale heupprothese hebben laten plaatsen in de periode van 25 februari 2008 tot en met 28 maart 2008.  Deze steekproef bestond uit 10 vrouwen en 6 mannen, met een gemiddelde leeftijd van 71,75 jaar (gaande van 59 tot 80 jaar). 

Van deze 16 patiënten hadden 10 patiënten de preoperatieve informatiesessie bijgewoond. Om het effect na te gaan van deze informatiesessie werden individueel per patiënt gegevens verzameld, na het ondertekenen van een informed consent- document, over: de copingstijl van de patiënt, de pijnervaring postoperatief, de postoperatieve mobilisatie van de patiënt, de tevredenheid van de patiënt bij ontslag en de hospitalisatieduur van de patiënt.

De copingstijl werd geëvalueerd aan de hand van een vragenlijst. Een duidelijk onderscheid tussen monitor-copingstijl en blunter-copingstijl werd gemaakt en wordt beschreven in het eindwerk.

Het pijnniveau postoperatief werd bepaald aan de hand van de Visuele Analoge Schaal die op verschillende tijdstippen tijdens de hospitalisatie werd afgenomen.

Het effect van de preoperatieve informatie op de postoperatieve mobiliteit werd gemeten aan de hand van het tijdstip waarop een bepaalde mobiliteit (bv. transfer in-uit bed) kon worden bereikt. Dit werd vergeleken met het tijdstip waarop dit volgens het klinisch pad zou moeten kunnen.

Om de patiënttevredenheid na te gaan, werd een tevredenheidsvragenlijst opgesteld. Ook deze lijst werd op verschillende tijdstippen ingevuld.

De hospitalisatieduur werd eveneens genoteerd. Volgens het klinisch pad in het A.Z. Sint-Lucas zou een patiënt gemiddeld op de zevende dag postoperatief het ziekenhuis moeten verlaten na het plaatsen van een totale heupprothese.

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Universiteit of Hogeschool
Verpleegkunde
Publicatiejaar
2008
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