Total hip replacement (THR) is a surgery applied to patients with end-stage osteoarthritis (OA), which is associated with severe and moderate pain in the postoperative period. OA is a serious disease that develops in about ten percent of adults and older adults, while this number is expected to increase twofold because of aging tendencies (Tsinaslanidis et al., 2020). In developed countries, the costs for THR account for between 1-2.5% of the gross domestic product (GDP) (Tsinaslanidis et al., 2020).The majority of patients having THR experiences difficulties with returning to their hobbies and sports. The reduction of health-related quality of life is a problem that requires exploring the best strategies to handle pain. Medication-based analgesia and aerobic stretching are the two main ways to help patients with pain in the perioperative period and recovery time (Karlsen et al., 2015). However, it is still unclear which of them is more effective and how to use them in the mentioned patients.
Currently, the evidence contains ambiguous data about the effectiveness of analgesia since it is often associated with side effects and lower quality of life. In turn, the role of aerobic stretching is underexplored in the literature. In practice, it is critical to ensure that nurses are aware of the recent evidence-based interventions and have sufficient skills and knowledge to implement them (Melnyk & Fineout-Overholt, 2018). Patient education that is considered to be one of the cornerstones of modern medicine cannot be provided without proper staff training. Therefore, they need to receive clear guidelines about pain management in patients with THR, which should be based on academic studies.
Considering the identified problem background and the need for change, the PICOT question can be formulated as follows:
- In adults with total hip replacement (P), what is the effect of pain medication (I) compared to aerobic stretching (C) in controlling post-operative pain (O) during the perioperative and recovery time (T)?
References
Karlsen, A. P. H., Geisler, A., Petersen, P. L., Mathiesen, O., & Dahl, J. B. (2015). Postoperative pain treatment after total hip arthroplasty: A systematic review. Pain, 156(1), 8-30.
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Lippincott Williams & Wilkins.
Tsinaslanidis, G., Tsinaslanidis, P., & Mahajan, R. H. (2020). Perioperative pain management in patients undergoing total hip arthroplasty: Where do we currently stand? Cureus, 12(7), 1-8.