Pain and nutrition as experienced by patients with hip fracture

Abstract

The purpose of this study was to investigate patients' experiences of care in connection with hip fracture. The care process was examined through non-participant observation, informal field interviews and healthcare records. The findings showed that many factors in the healthcare services directly or indirectly influence patients' perceptions of the quality of care. Some of these factors may depend upon a varying knowledge and empathy, while others are due to a lack of agreed protocols/procedures. Patients' needs with respect to pain relief and nutrition are discussed.

Registered nurses and enrolled nurses assessments of postoperative pain and risk for malnutrition and pressure ulcers in patients with hip fracture

“…Management of acute postoperative pain is a central issue in elderly patients with hip fracture. However, pain is often under-assessed and patients need to be relieved from pain to become mobile (Hallström et al, 2000). It is also important to assess pain and give pain relief to avoid PU (Hommel, 2007).…”

Patients’ Decision-Making Strategies for Managing Postoperative Pain

“…[25][26][27][28]40,42 Although the literature is replete with prescriptive models of how patients should make decisions, 10,21,22,24,31,34,43 no studies were identified that specifically examined patient strategies for making decisions about managing their pain in actual practice. Instead, patients' perspectives on pain management have mainly been addressed with descriptions of their experience, 1,[7][8][9]16,19 their perceived satisfaction with care activities, 20,23,37 and their attitudes concerning the pain experience. 5,39 Common postoperative experiences relating to pain management include patients' refusal to accept analgesia, 8 patients behaving passively about asking for analgesia, and patients believing they have to tolerate pain.…”

“…5,39 Common postoperative experiences relating to pain management include patients' refusal to accept analgesia, 8 patients behaving passively about asking for analgesia, and patients believing they have to tolerate pain. 8,16 Patients may not disclose pain to clinicians because they are perceived to be too busy. 5,9,16,41 There is also a tendency for patients not to actively communicate with clinicians following operations about how they want their pain to be treated.…”

“…8,16 Patients may not disclose pain to clinicians because they are perceived to be too busy. 5,9,16,41 There is also a tendency for patients not to actively communicate with clinicians following operations about how they want their pain to be treated. 19 Satisfaction with pain management after surgery occurs when patients are included as an informed partner in discussions about analgesia options, 37 when pain is relieved effectively even though some degree of discomfort is anticipated, 23 and when clinicians show concern about how much pain patients are experiencing.…”

“…12,17,18,29,36 Contextual issues may include the nurses' ability to encourage patient involvement, the availability of health professionals with an expert understanding of analgesic needs, and the ways in which information is communicated among clinicians and between patients and clinicians. Aside from the observational work by Hallström et al 16 on patients following hip fracture, research on patient perspectives has involved survey and interview methods. Hallström et al 16 observed 9 patients for approximately 20 h each, from admission in the emergency department to post-discharge.…”