Diagnosing for the nursing care needs of acute pain using a NANDA system of diagnosis classification (North American Nursing Diagnosis Association) in patients after hip replacement

Objectives: Empirical verification of the nursing diagnosis of acute pain using the NANDA diagnosis classification system in patients after the hip replacement surgery.

Material and methods: The study was conducted at the Department of Trauma and Orthopedic Surgery with the Arthroplasty Unit at the Health Care Centre in Starachowice from 20 April to 14 June 2013. The study was performed on 50 patients (32 women and 18 men) after the hip replacement surgery.

The study used the diagnostic survey, analysis of medical records and the method of check-lists.

Results: In the assessment of pain using the Numerical Rating Scale (NRS) on the first day after surgery, severe pain was found in 4% of patients, and serious in 20%, while on the second day, it was 0% and 10%, respectively. Among the analyzed indexes accompanying pain, the most common occurrence of the following features was noted: altered facial expression, increased muscle tone, difficulty in daily self-care activities, inability of deep breathing and serious sleep disorders. The mean body mass index (BMI) in the group of patients was 28.63 ±3.03 kg/m².

Conclusions: Acute pain is a specific problem in the group of patients after hip replacement surgery and it is mostly mild and moderate. Pain intensity in the group has a tendency to change from moderate (22%) and mild pain (74%) on the first day after surgery to mostly mild pain (78%) on the second day after surgery. A statistically significant correlation between BMI and severity of acute pain in the study group was observed.