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Patient satisfaction and the willingness to recommend a hospital are critical for healthcare quality improvement. This study focuses on orthopedic patients, recognizing their unique healthcare experiences. We aimed to explore factors influencing orthopedic patients' willingness to recommend the hospital, considering various demographic and clinical variables. A cross-sectional survey of 200 orthopedic patients hospitalized between July and December 2023 in north-central Israel was conducted. Results revealed a positive association between age and willingness to recommend (odds ratio [OR] = 2.44), while emergency department stay length showed a negative association (OR = 0.58). Satisfaction with hospital care positively influenced the willingness to recommend (OR = 1.96). Gender, comorbidities, and hospital stay length did not significantly impact willingness to recommend. The study highlights the role of satisfaction and the impact of extended emergency department stays, emphasizing the need for nuanced strategies to optimize orthopedic patient experiences. Valuable insights are offered for healthcare providers and policymakers. [ABSTRACT FROM AUTHOR]

Background: Research indicates that the psychological well-being of orthopedic patients can benefit from a robust social support system that offers emotional assistance both before and after surgery. However, the impact of social networks on mental health outcomes remains inconclusive due to variations in availability. Objectives: This study investigated the influence of support from family and friends in the relationship between post-traumatic stress disorder (PTSD) and emotional distress among orthopedic patients in Nigeria. Materials and Methods: The study employed a hospital-based research design, using the 17-item PTSD self-report measure (PCL-C) and depression anxiety stress scales (DASS-21) to assess psychological distress and dimensions of social support from friends and family, involving 542 orthopedic patients from the National Orthopedic Hospital in Enugu, Nigeria. Results: The findings revealed a significant association between PTSD and emotional distress (β = 0.866; t = 9.245; P < 0.001). Family support was found to exacerbate emotional distress among orthopedic patients (β = 0.448; t = 4.176; P < 0.001), while support from friends showed an inverse effect on emotional distress (β = −0.310; t = −2.880; P < 0.01). Moreover, moderation analysis indicated that high family support reduces the effect of PTSD on emotional distress for orthopedic patients (β = −0.035; t = −3.539; [CI: −0.055, −0.016], P < 0.01). Conclusion: The study recommends prompt intervention for orthopedic patients to enhance their well-being by leveraging the available support from family and friends to alleviate the emotional distress associated with PTSD. Additionally, it underscores the importance of educating families and friends of orthopedic patients on their role in supporting the patient’s recovery journey.

OBJECTIVE: Surgical site infection (SSI) is a devastating complication in orthopedic surgery. Methicillin-resistant Staphylococcus aureus (MRSA) is a notorious organism in SSI, especially in orthopedic patients. We aimed to understand the association between MRSA carriers and the rate of SSI caused by MRSA in orthopedic patients. PATIENTS AND METHODS: We prospectively performed a cohort investigation on patients admitted to the Department of Orthopedic between April and August 2023. Samples were taken preoperatively from the nose and post-operatively in surgical wounds. All samples were grown in MeReSa Agar and defined as positive with MRSA characteristics. Data analysis was performed using SPSS Statistics. A significant difference between groups was assessed using either the Chisquare test or Fisher's exact test. Statistical significance was set at p<0.05. RESULTS: We obtained 526 nasal swabs of patients, and 140 (26.6%) samples were positive for MRSA. Our study revealed significant associations between MRSA carriers and the following factors: history of recent hospitalization (OR: 1.81; 95% CI: 1.172-2.795; p=0.007), smoking history (OR: 1.55; 95% CI: 1.011-2.383; p=0.044), and antibiotic exposures (OR: 2.19; 95% CI: 1.305-3.703; p=0.003). Our findings showed a significant association between SSI and the following factors: history of antibiotic exposures (OR: 2.89; 95% CI: 1.264-6.566; p=0.003), blood loss volume >500 ml (OR: 2.522; 95% CI: 1.245-5.108; p=0.008) and contaminated surgical wounds (OR: 5.97; 95% CI: 2.907-12.266; p=0.001). Patients with MRSA carriers tended to have an increased risk of having an MRSA SSI with an odds ratio of 3.44 (95% CI: 1.13-10.48; p=0.047). CONCLUSIONS: Our study highlights the increased risk of MRSA carriage in patients with a history of smoking, recent hospital admission, or antibiotic exposure. Our reports also identify potential risk factors for SSI, such as previous antibiotic exposure, blood loss, and contaminated wounds. Furthermore, our research establishes an association between MRSA colonization and MRSA SSI, which emphasizes the criticality of decolonization strategies. A further prospective multicenter study is needed to elaborate on our study findings. [ABSTRACT FROM AUTHOR]

Introduction: Chronic non-cancer pain (CNCP) negatively impacts patient quality of life. Analgesics remain the main treatment for CNCP. However, little is documented about analgesic use and the pain characteristics among orthopedic patients with CNCP. Objective: This study aimed to evaluate the analgesic use and pain characteristics among orthopedic patients with CNCP. We identified the reasons for analgesic underuse and examined the factors associated with analgesic underuse. Methods: A cross-sectional study was conducted involving orthopedic patients with CNCP from the Orthopedic Clinic between September and December 2021. Data was collected at initial clinic visit and at Week 4 via telephone follow-up. The Numerical Rating Scale was used to determine pain scores. Results: 156 patients (62.2% female, mean age 56.7 years) were recruited with most diagnosed with osteoarthritis (27.6%) and degenerative diseases (24.4%). More than one-third of the patients were on single oral analgesics and 7.1% were not on any oral analgesics. Paracetamol was the common choice of analgesic for both single or combination analgesics regimen. Most (47.2%) of the analgesics were prescribed as needed. The pain score reduced significantly with initial median pain score of 6 (IQR 4-7) to 5 (IQR 3-6) at Week 4, p<0.001. Almost three-quarter (67.4%) of the patients underused their analgesics with most citing the reason being that the pain was tolerable. Oral analgesic was found to be significantly associated with analgesic underuse (p=0.022). Conclusion: Analgesics were generally underused. Further exploration into patient perceptions, beliefs, and factors affecting the pain tolerance is warranted. [ABSTRACT FROM AUTHOR]

Objective: This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient‐reported outcomes measures (PROMs) in people with knee osteoarthritis (OA). Methods: This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self‐reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random‐effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA. Results: Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta‐analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = −0.33, 95% CI = −1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self‐reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole‐body electrostimulation combined with exercise. Conclusion: This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high‐quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole‐body configuration combined with exercise shows promise as an alternative treatment option. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the frequency of postoperative constipation and risk factors in orthopedic patients. A descriptive model was used. A total of 140 patients who underwent surgical intervention in the Orthopedics and Traumatology Clinic were included in the present study. The Descriptive Characteristics Form, Constipation Risk Assessment Scale, and Visual Analog Scale were used to collect the study data. Frequencies, percentages, Mann Whitney U , Kruskal-Wallis, and Spearman Correlation tests were used to evaluate the data. In the present study, 72.1% of the individuals experienced constipation during the hospitalization period, and the constipation risk score was 12.77.á...á4.83. Those who were female, over 65 years old, unemployed, had lower extremity surgery, used opioid analgesics, were dependent on their activities, had prehospital constipation, had a chronic disease, and used drugs regularly had higher constipation risk scores at statistically significant levels. A significant correlation was detected between the constipation risk score and age, pain severity, hospital stay, time to first defecation after surgery, and the amount of fluid consumed daily. The majority of the individuals experienced constipation during the hospitalization period, and the constipation risk score was moderate. Those who were female, had advanced age, were unemployed, had high pain severity, opioid use, previous constipation, chronic disease, regular medication, long hospital stay, those whose first defecation period was prolonged after the surgery and whose fluid intake was insufficient had a higher risk of constipation. In this regard, nurses must evaluate orthopedic patients in terms of constipation risk factors and apply nondrug methods that prevent and relieve constipation with laxatives. [ABSTRACT FROM AUTHOR]

This study aimed to guide the efforts to improve the efficiency of healthcare by revealing the demographic data and disease profile of patients applying to a state hospital which was the only secondary healthcare institution in aregion, and which had only one orthopedic specialist. The study included the patients who applied to the Orthopedics and Traumatology outpatient clinic of the state hospital in Kestel District Town of Bursa Province in Turkey in the 1 March 2019-29 February 2020 period. The ages, genders, complaints, diagnoses, involved body partsof the patients admitted during this period as well as treatment modalities used were given in tables and figures. A total of 13,397 patients who applied to the Orthopedics and Traumatology Department with various complaints were included in the present study. Of all patients, 4,469 were men (33.3%) and 8,928 were women (66.6%). It was revealed that 4,984 patients (37.2%) applied to a primary healthcare institution first for theircurrent complaints whereas 8,413 patients (62.8%) used the Orthopedics and Traumatology Outpatient Clinic as a primary healthcare center. The most common complaint to apply the outpatient clinic involved knee (39%) followed by foot-ankle (16%) and hand-wrist (12%). The most common diagnoses made for the patients who applied during the study period were arthritis (30%), tendinopathy/enthesopathy (16.6%), and soft tissue injuries (15.7%). Primary healthcare examinations were requested for most patients, and only a small percentage of patients needed secondary healthcare examinations. A high percentage of patients were treated in our secondary healthcare center and very few of the patients were referred to tertiary healthcare institutions. There is a considerable patient density in health institutions in Turkey. Especially orthopedic physicians in secondary healthcare institutions have a high number and variety of patients. There is a need to improve health policies in this regard. [Med-Science 2020; 9(4.000): 935-8]

Question: Comorbidity, i.e., additional psychological distress in patients already suffering from chronic somatic diseases (e.g., orthopedic conditions) is of growing importance. The quality of analyzing and interpreting the often used Brief Symptom Inventory (BSI) used with orthopedic patients should improve by employing a new "case definition" of four groups (instead of two) of differentially psychologically distressed patients instead of two groups as before. Methods: Four groups with the different psychological distress definitions of "no," "mild," "remarkable," and "severe" were to be analyzed from a group of 639 orthopedic patients in inpatient rehabilitation clinics. The BSI is transformed into T values (M =50, SD=10). There is "no" distress if no T [two scales] is ≥60 and "mild" distress if T [two scales] and/or T [GSI] is ≥60 and <63. If T [two scales] and/or T [GSI] is ≥63 and <70, it is "remarkable," and if T [two scales] and/or T [GSI] ≥70, it speaks for "severe" psychological distress. Results: The new tool for analyzing psychological distress based on the T-scores of the BSI resulted in the following four groups: No psychological distress (41.9%): unspecific health-related information stands for a useful intervention. About 13.3% demonstrated low psychological distress: shorter diagnostic interviews and a few more diagnostic examinations led to a low-level outpatient group program to improve health and well-being in a preventive sense; one repeated measurement in 4weeks is advised. Remarkable psychological distress (26%): in-depth exploration using interviews, tests, and questionnaires to choose specific interventions in a single and/or group setting, outpatient or inpatient treatment; repeated measurements and process control. About 18.8% reported severe psychological distress: in-depth exploration led to specific interventions in a single and/or group setting, almost an inpatient setting; immediately crisis intervention and high-frequent process control. Conclusion: The new evaluation strategy of the BSI should improve practice and research; further investigation is necessary. [ABSTRACT FROM AUTHOR]

Question: Comorbidity, i.e., additional psychological distress in patients already suffering from chronic somatic diseases (e.g., orthopedic conditions) is of growing importance. The quality of analyzing and interpreting the often used Brief Symptom Inventory (BSI) used with orthopedic patients should improve by employing a new “case definition” of four groups (instead of two) of differentially psychologically distressed patients instead of two groups as before.Methods: Four groups with the different psychological distress definitions of “no,” “mild,” “remarkable,” and “severe” were to be analyzed from a group of 639 orthopedic patients in inpatient rehabilitation clinics. The BSI is transformed into T values (M=50, SD=10). There is “no” distress if no T [two scales] is ≥60 and “mild” distress if T [two scales] and/or T [GSI] is ≥60 and

Aim: Assessment of the sense of coherence, methods of coping with stress and the relationship between their components among people after orthopedic surgery. Materials and methods: 100 people were examined. The proper group consists of 50 patients after orthopedic surgery. The control group consists of 50 healthy people. All the subjects completed a questionnaire with questions about basic metrical data and two standardized questionnaires: SOC-29 and Mini-COPE. The results underwent statistical analysis. Results: Both groups did not differ in the level of the sense of coherence, the distribution was notably similar to normal (p > 0,05). However, the differences in the strategies of coping with stress were observed. Differences in correlations between individual coherence components and remediation strategies have also been noticed. Conclusions: The patients were characterized by a greater intensity of non-constructive coping strategies compared to the control group. Only among them the stronger sense of coherence coexisted with lower inclinations to negative patterns of behavior. Higher global life orientation was associated with a more favorable and positive approach to problems among healthy people.

The contribution of anesthetic procedure to surgical stress and postoperative complications has been attributed to increased oxidative stress and release of inflammatory cytokines. Thus, the levels of oxidative stress biomarkers and inflammatory cytokines in patients with general anesthesia (GA) and spinal anesthesia (SA) that underwent open reduction and internal fixation (ORIF) in orthopedic surgery at Federal Teaching Hospital, Ido-Ekiti, Ekiti state, Nigeria were investigated. Forty patients were randomly distributed into two groups (n = 20) namely GA and SA. Blood samples were collected before and after surgery for estimation of glucose, oxidative stress biomarkers (malondialdehyde [MDA], glutathione, catalase and nitrile) and inflammatory cytokines (tumor necrosis factor-α [TNF-α] and interleukin-6) levels. The post-operative blood glucose level was higher than the pre-operative value (p<0.5) in the two groups. There were significant (p<0.05) changes in MDA concentration and catalase activity in patients with GA in the post-operative stage relative to preoperative phase. There were no significant differences in glutathione, nitrite and interleukin-6 contents between the two groups. The patients with SA had higher levels of TNF-α in the post-operative stage. These findings suggest that anesthesia has differential effects on oxidative stress and inflammatory cytokines in patients with ORIF orthopedic surgery. [ABSTRACT FROM AUTHOR]

To our knowledge this is the first study presenting descriptive EQ-5D health profile and VAS scores for orthopedic patients in Slovenia. Furthermore, EQ-5D-3L population norms for Slovenia are presented. The aims of this study are (1) to provide population norms for EQ-5D-3L in Slovenia according to age and sex and (2) to compare different groups of orthopaedic patients' health state among themselves as well as to the general population. Data on orthopedic patients' preoperative health status assessment were recorded (n = 1118). The health status of 4 groups of orthopedic patients was analyzed and compared using EQ VAS and the EQ-5D descriptive profile. The results were compared with Slovenian population norms, which were calculated using the EQ-5D valuation set database from year 2000 (n = 708). As expected, a higher proportion of patients than the general population report problems on all dimensions. The opposite is true only for mobility and anxiety/depression dimension for shoulder surgery patients. Hip endoscopy patients have the lowest health-related quality of life (HRQoL) out of all patient groups using EQ VAS and EQ-5D descriptive profiles. The population norms presented will be useful for many researchers trying to compare HRQoL among various patient groups or the general population. Separate use of the descriptive profile of the EQ-5D is informative when assessing HRQoL in orthopedic patients and is in line with VAS values. The results can support further studies on health needs assessment as well as decisions on funds allocation among groups of orthopedic patients. [ABSTRACT FROM AUTHOR]

This study was aimed to determine the prescribing pattern and drug interaction of an antibiotic at a private hospital using WHO recommended indicators. A cross-sectional study was conducted for six months to evaluate drug utilization pattern and drug interaction of an antibiotic prescribed at an orthopedic unit at a private hospital. The drug utilization and drug interactions were studied on a total of 200 prescriptions. The average number of prescribed drugs was found 5.15 per prescription. The maximum number of patients were treated with a single antibiotic. In this study, we observed that most of the patients were at the age range of 61-70 years. In our study, 22% of drugs were prescribed by generic names and 78% were the drugs prescribed by their brand names. The most frequently prescribed antibiotic group was beta-lactam drug. The most common situation was accident in which antibiotics were prescribed in a higher ratio. No serious drug interaction was found. Mostly all the possible drug interactions occur through the pharmacokinetic mechanism. The number of medicines per prescription should be kept in minimum with an eye on therapeutic effect. In other words, rational drug must be strictly followed. Polypharmacy and combination of drugs have to be discouraged to minimize drug interactions. [ABSTRACT FROM AUTHOR]

Hand edema is a common post-surgical or traumatic complication in orthopedic patients, necessitating effective treatment interventions. This study aimed to investigate the effects of two different types of bandages, along with finger flexion exercises, on managing hand edema. Our orthopedic patients with post-surgical or traumatic hand edema and three non-edematous hands were enrolled in the study. A mixed model effect with fixed factors of time (pre-post) and bandage type (M, C, N), and random factors of hand, edema, fingers, and phalanges was applied. The bandage types were circular with short elastic bandage (M) and circular with elastic bandage (C). Finger flexion exercises involved alternating contractions of extrinsic and intrinsic flexors. Randomization ensured unbiased allocation to bandage types. The M bandage demonstrated a significant reduction in hand edema by effectively moving free fluids, reinforcing tissue hydrostatic pressure, and facilitating venous and lymphatic flow. On the other hand, the C bandage did not produce significant pre-post differences in hand circumference. The combination of a circular bandage with finger flexion exercises shows promise in reducing hand edema in orthopedic patients. Particularly, the stiff bandage M exhibited superior efficacy compared to the elastic one C in reducing hand circumference. These findings provide valuable insights for clinical practice, offering an effective strategy for managing hand edema and promoting better patient outcomes. • Effective "M" short elastic bandage: "M" bandage significantly reduces edema. • Enhanced patient care: Promising edema management strategies. • Clinical impact is achievable: Improved hand edema care outcomes [ABSTRACT FROM AUTHOR]

Purpose: To estimate the discriminative value of serum P1NP/βCTX ratio and albumin levels in hospitalized orthogeriatric patients with and without nonvertebral fractures. Methods: In 1,239 orthogeriatric patients (mean age 78.1±9.52 years, 69.1% women) including 854 (68.9%) with osteoporotic nonvertebral fractures (455 [36.7%] with hip fracture [HF]) and 385 (31.1%) without fractures, markers of bone formation (procollagen type 1 N-terminal propeptide [P1NP], osteocalcin [OC], and bone resorption (beta-C-terminal cross-linking telopeptide of type 1 collagen [βCTX]), indices of mineral metabolism, and parameters of liver and renal functions were assessed; data on clinical and laboratory characteristics were collected prospectively. Results: Both lower serum P1NP/βCTX ratio and albumin concentration (as continuous or categorical variables) were independently associated with fracture presence in multivariate logistic regressions. Compared with the highest P1NP/βCTX tertile, the prevalence of HF, after adjustment for multiple covariates, was 3-fold higher in the lowest tertile and 1.5 times higher in the middle tertile; presence of any fracture was 2.3- and 1.6-fold higher, respectively; patients with albumin levels in the lowest tertile had multivariate odds ratio (OR) of 4.6 for HF and 2.8 for any fracture, in the middle tertile the ORs were 2.2 and 1.3, respectively. The P1NP/βCTX ,100.0 (median) and hypoalbuminemia (,33 g/L) demonstrated area under the curve values for HF of 0.802 and 0.806, respectively, and for any fractures of 0.711 and 0.706, respectively. When both characteristics were combined, the ORs for HF or any fracture, compared with the nonfractured group, were 7.8 and 3.2, respectively, with an accuracy of 79.6% and 71.6%, respectively. Conclusions: In orthogeriatric patients, both serum P1NP/βCTX ratio and albumin levels demonstrated an inverse dose–effect relationship with the prevalence of nonvertebral fractures and independently indicated fracture presence with acceptable discriminatory power. Lower P1NP/βCTX (,100) and hypoalbuminemia could be useful simple additive prognostic tools for fracture risk stratification in the elderly. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to describe pain intensity before and after watching funny and unfunny videos on post-surgical pain levels. Methods Ninety patients were divided into three groups. Group A watched funny videos, Group B watched unfunny videos, Group C did not watch any videos. Pain assessment of the patients was carried out before (first), immediately after (second), and 30 min after (third) watching videos. Results The first pain scoremean in Group A was 40.83 ± 22.62, in Group B was 37.46 ± 24.31, in Group C was 48.86 ± 24.06. The second pain scoremean in Group A was 32.93 ± 20.28, in Group B was 29.76 ± 20.26, in Group C was 48.96 ± 24.11. The third pain scoremean in Group A was 37.43 ± 23.07, in Group B was 36.80 ± 22.67, in Group C was 52.30 ± 23.97. Conclusion Watching funny or unfunny videos reduces the post-surgical pain level. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this qualitative study was to investigate what design features of hospital rooms are valued by inpatients. Background: Little research has explored how patients evaluate the physical environment of their hospital rooms. Most responses are captured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which includes only two questions about the physical environment. Method: Two hundred thirty-six orthopedic patients (78 in the United States and 158 in Portugal) listed three features of their hospital room that influenced their level of satisfaction with their hospital stay, indicating whether the feature was positive or negative. Results: The comments were more positive (71.4%) than negative (28.6%). Using the framework of supportive design from Ulrich, over half the comments (64.31%) could be categorized in one of the three dimensions: 33.2% (positive distraction), 22.4% (perceived control), and 6.0% (social support). This total includes Internet (2.7%), which could be categorized as either social support or positive distraction. Comments called “other aspects” focused on overall environmental appraisals, cleanliness, and functionality and maintenance. Conclusions: The majority of comments could be accommodated by Ulrich’s theory, but it is noteworthy that other aspects emerge from patients’ comments and affect their experience. Cross-cultural differences pointed to the greater role of light and sun for Portuguese patients and health status whiteboard for U.S. patients. Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions. [ABSTRACT FROM AUTHOR]

Background: Acute joint or chronic musculoskeletal pain is common among orthopedic patients. After the pain assessment for effective pain management, both the pharmacological and non-pharmacological approaches must be used. Objectives or Aims: To improve the quality of care in acute or chronic pain, this systematic review was find out what kind of non-pharmacological interventions used for reducing pain in orthopedic patients. Methodology: The computer-assisted search was performed using the databases of Medline, Pubmed, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The search was performed using both MeSH terms and keywords by the option ‘search all text'. The nursing studies selected were those published from 2002-2012. The Oxford 2011 Levels of Evidence was used to appraise the literature. 17 studies were extracted and further reviewed. Results: According to reviewed studies, self management programs, relaxation techniques, guided imagery, listening to music, and back massage are defined as helping to ease the intensity of pain in orthopedic patients. Conclusions: With this study, nurses can gain specific knowledge on the most preferred and used nonpharmacological interventions in orthopedic patients. For effective pain management, nurses can implement these interventions safely. [ABSTRACT FROM AUTHOR]

Background. The aim of our study was to identify the opinion of patients on the quality of medical services provided to them in our post anaesthesia care unit (PACU). Material and methods. Participants in the study were 200 patients underwent various orthopedic procedures. We used the own, pilot questionnaire with ten questions related to assessment of the work of nurses and doctors. Results. The very positive were the patients' ratings concerning the quality of nurses' work, their solicitude, kindness and commitment. Answers to questions about the work of doctors were not significantly satisfactory although it should be emphasized that about 50% of the respondents rated the doctors work very well. The doctors' attention and care were rated very well/excellent by 57% of the respondents. The weak assessment focused mainly on the accessibility of doctors and their reaction to the pain of patients. Conclusion. We hope that our findings help us to better identify and solve the problems relate to quality of care for the postoperative patients. [ABSTRACT FROM AUTHOR]

Aim Patients' perspectives on their condition and treatment, their sense of need for healthcare, and their preferences for care and outcomes are all addressed by quality of life metrics. Therefore, it is important to all health professionals and patients involved in orthopedic surgery. This study aimed to evaluate the quality of life after orthopedic procedures and how its results could potentially be used for future improvement. Methods This is a cross-sectional study conducted among patients who underwent orthopedic procedures at Buraydah Central Hospital (BCH) and King Fahad Specialist Hospital (KFSH). A self-administered questionnaire was distributed among the patients using a paper questionnaire. The questionnaire was composed of socio-demographic data (e.g. age, gender, education, etc.) and the 36-Item Short Form Survey (SF-36) to measure patients' quality of life. Results In this study, 215 patients were able to complete the survey (male 82.3% vs female 17.7%). The most common age group was 18 to 30 years old (30.2%) and the most common surgery performed on patients was thigh surgery (19.5%) and hand surgery (13%). The overall mean physical health score after the surgery was 51.1 (SD 11.8) higher than the mental health score (mean 47.7; SD 11.2). Poor quality of life was significantly more common among patients with chronic disease while poor physical functioning and general health subdomains were more associated among patients who underwent hand surgery. Conclusion Patients suffering from chronic diseases tend to exhibit a low quality of life as compared to other patients. The quality of life after the surgery is an important indicator of patient satisfaction which may have a direct impact on the future outlook of a patient. More research is needed to determine the overall quality of life in patients who underwent a surgical procedure in our region., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alharbi et al.)

Background: Patients with complex health conditions frequently require care from multiple providers and are particularly vulnerable to poorly executed transitions from one healthcare setting to another. Poorly executed care transitions can result in negative patient outcomes (e.g. medication errors, delays in treatment) and increased healthcare spending due to re-hospitalization or emergency room visits by patients. Little is known about care transitions from acute care to complex continuing care and rehabilitation settings. Thus, a qualitative study was undertaken to explore clinicians' perceptions of strategies aimed at improving patient care transitions from acute care hospitals to complex continuing care and rehabilitation healthcare organizations.Methods: A qualitative study using semi-structured interviews was conducted with clinicians employed at two selected healthcare facilities: an acute care hospital and a complex continuing care/rehabilitation organization, respectively. Analysis of the transcripts involved the creation of a coding schema using the content analyses outlined by Ryan and Bernard. In total, 31 interviews were conducted with clinicians at the participating study sites.Results: Three themes emerged from the data to delineate what study participants described as strategies to ensure quality inter-organizational transitions of patients transferred from acute care to the complex continuing care and rehabilitation hospital. These themes are: 1) communicating more effectively; 2) being vigilant around the patients' readiness for transfer and care needs; and 3) documenting more accurately and completely in the patient transfer record.Conclusion: Our study provides insights from the perspectives of multiple clinicians that have important implications for health care leaders and clinicians in their efforts to enhance inter-organizational care transitions. Of particular importance is the need to have a collective and collaborative approach amongst clinicians during the inter-organizational care transition process. Study findings also suggest that the written patient transfer record needs to be augmented with a verbal report whereby the receiving clinician has an opportunity to discuss with a clinician from the acute care hospital the patient's status on discharge and plan of care. Integral to future research efforts is designing and testing out interventions to optimize inter-organizational care transitions and feedback loops for complex medical patients. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study was to evaluate the discriminant and concurrent (criterion-related) validity of a recently introduced floor-based photocell system (Optogait, Microgate, Bolzano, Italy) with a validated electronic walkway for the assessment of spatiotemporal gait parameters. Fifteen patients (mean age±standard deviation: 65±7 years) with total knee arthroplasty and 15 healthy matched control subjects were asked to walk at different velocities while gait variables were recorded simultaneously by the two instruments. The Optogait and the criterion instrument detected the same differences in walking parameters between patients and controls. Intraclass correlation coefficients ranged between 0.933 (swing time) and 0.999 (cycle time, cadence and walking speed). Cycle time and stance time were significantly longer, while swing time, step length, cadence and walking speed were significantly lower for Optogait (p <0.001) compared to the criterion instrument. The Optogait system demonstrated high discriminant and concurrent validity with an electronic walkway for the assessment of spatiotemporal gait parameters in orthopedic patients and healthy controls. However, the two measuring instruments cannot be used interchangeably for quantitative gait analysis, and further validation of floor-based photocell technology is warranted. [Copyright &y& Elsevier]

Background: Hepatitis B and C is a global problem. The prevalence of hepatitis B and C in orthopedic patients is quite high with the common risk factors: previous history of surgery or blood transfusion. Objectives: The objectives of this study were to, "Find out the prevalence of Hepatitis B and C and their risk factors in patients admitted in Orthopedic Unit of Sheikh Zayed Medical College Hospital Rahim Yar Khan.". Design & Duration: This was a prospective cohort study. The duration was from July 2009 to December 2009. Patients and Methods: This study was conducted in Orthopedic Department of Sheikh Zayed Medical College Hospital Rahim Yar Khan. Patients of either sex and of all ages who were undergoing orthopedic surgery were included in the study. All patients underwent screening for Hepatitis-B and Hepatitis-C and confirmed by Elisa method in positive patients. Data regarding age, sex, HBV, HCV was noted and analyzed by SPSS version 14. Results: Among 745 patients. 581 (77.98%) were male and 164 (22.02%) were female. Hepatitis B and C was present in 165 (22.15) patients. Out of these positive cases 125 (75.76%) were suffering from hepatitis C and 36 (21.81%) were suffering from hepatitis B, and 4 (2.43%) patients were positive for both HBV & HCV. Among the predisposing factors previous history of surgery was positive in 39 patients; history of blood transfusion in 27 patients, dental procedure was in 17 patients' and 123 patients having injection therapy in the past. Conclusions: All the patients who need surgery should be properly screened for HBV and HCV. It is also necessary that separate operation theaters and instruments should be used for HBV and HCV positive cases. [ABSTRACT FROM AUTHOR]

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Inadvertent postoperative hypothermia is common among patients in the postanesthesia care unit (PACU). Shivering traditionally is attributed to hypothermia, but it Is not always thermoregulatory. The exact impact of hypothermia and shivering on standard PACU monitoring parameters of patients has not been sufficiently studied. The present study included 170 orthopedic surgical patients. On PACU arrival, we recorded the incidence of hypothermia and shivering, as well as heart rate, mean arterial blood pressure, and oxygen saturation of all subjects. Analysis of covariance was used to investigate the effects of hypothermia and shivering on these monitoring parameters. Among orthopedic patients, 73.5% of them had hypothermia and 24.7% experienced shivering, which was observed primarily in hypothermic patients. Mean arterial blood pressure was significantly higher in hypothermic patients, and heart rate was significantly higher in shivering patients, whereas oxygen saturation was not affected by hypothermia or shivering. Our data confirm that standard PACU monitoring parameters are affected partially by hypothermia and shivering. A low incidence of shivering in normothermic patients and a high incidence of shivering in younger patients are discussed. Limitations of this study are reported. [ABSTRACT FROM AUTHOR]

One hundred and seventy-four patients with orthopedic and musculoskeletal problems received computed tomography (CT) scans between January 1979 and July 1980. There were 34 trauma patients, 35 patients with known or suspected primary tumors, 20 patients with metastases, 18 patients with suspected spinal stenosis, 25 patients with disc problems, five patients with infections, 13 children with congenital anomalies, and 24 patients with miscellaneous problems. The CT scans proved useful in all the pediatric cases, 97% of the trauma patients, and in the majority of patients with tumors. It appears that absolute indications for CT scanning in orthopedic patients include acute trauma to the spine, pelvis, hip, and shoulder girdles as well as in children with congenital spinal anomalies. Relative indications include determining the extent of the tumor and also aiding in the correct approach for biopsying a lesion. [ABSTRACT FROM AUTHOR]

Background: Telemedicine is improving healthcare delivery in orthopedic patients but the data regarding this are scarce from India, especially North India., Methodology: During this one-year prospective observational study, all patients with fractures of the upper end of tibia requiring surgical intervention and who consented to avail teleconsultation services were included. All these patients were assessed by patient satisfaction score pre-operatively. Patients were randomly assigned for post-operative care schedules of 5 and 14 days in telemedicine and inpatient visits during their follow-up period., Results: A total of 50 patients were included and the satisfaction rating among the two groups was identical. The average patient satisfaction score (on a 10-point scale) was found to be 9.77 in the inpatient visits based on the one-on-one follow-up group and 9.79 in the telemedicine consultation group., Conclusion:  In orthopedics, the implementation of telemedicine can minimize the need for the patient to physically visit the outpatient department. The rates of response and overall patient satisfaction were high in the telemedicine group. However, more efforts should be made to address the limitations and problems of using telemedicine., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Sandhu et al.)

This study explores the relationship between inpatient unit design and patient experience and how spatial features and visibility impact patients' perception of staff responsiveness. The first part of this study is a retrospective pre-post and cross-sectional study evaluating the impacts of unit design on patient experience at the unit level. This study compares patient experiences based on Press Ganey and HCAHPS surveys in two orthopedic units (existing unit in Atrium building and new unit in Tower) with differing design features at Rush University Medical Center. The chi-square test results show that when moving from the old orthopedic unit to the new unit, almost all patient survey items related to patient experience showed statistically significant improvements. The second part of this study is a room level on the new unit. The ANOVA and Pearson correlation tests revealed that the visibility measure of metric step depth had significant impacts on patients' perception of staff's "promptness in responding to call button" and "help with toileting". This study confirms that inpatient unit design plays a direct role in improvement for patient experience and should be considered as an important area of focus for future development.

Objectives The contribution of anesthetic procedure to surgical stress and postoperative complications has been attributed to increased oxidative stress and release of inflammatory cytokines. Thus, the levels of oxidative stress biomarkers and inflammatory cytokines in patients with general anesthesia (GA) and spinal anesthesia (SA) that underwent open reduction and internal fixation (ORIF) in orthopedic surgery at Federal Teaching Hospital, Ido-Ekiti, Ekiti state, Nigeria were investigated. Methods Forty patients were randomly distributed into two groups (n = 20) namely GA and SA. Blood samples were collected before and after surgery for estimation of glucose, oxidative stress biomarkers (malondialdehyde [MDA], glutathione, catalase and nitrile) and inflammatory cytokines (tumor necrosis factor-α [TNF-α] and interleukin-6) levels. Results The post-operative blood glucose level was higher than the pre-operative value (p<0.5) in the two groups. There were significant (p<0.05) changes in MDA concentration and catalase activity in patients with GA in the post-operative stage relative to preoperative phase. There were no significant differences in glutathione, nitrite and interleukin-6 contents between the two groups. The patients with SA had higher levels of TNF-α in the post-operative stage. Conclusions These findings suggest that anesthesia has differential effects on oxidative stress and inflammatory cytokines in patients with ORIF orthopedic surgery.