Postoperative pain and its impact on quality of life for hip-fractured older people over 12 months after hospital discharge.

摘要

AIMS AND OBJECTIVES: To describe pain severity and pain interference and to explore the impact of pain severity on postoperative health-related quality of life of older people during their first year after discharge for hip surgery in Taiwan. BACKGROUND: Few studies have examined the impact of pain on postoperative quality of life for hip-fractured older persons. DESIGN: A descriptive, correlational design was used for this longitudinal study. METHODS: Pain intensity, pain interference and quality of life were investigated prospectively for 87 elders within 12 months after discharge for hip surgery at a medical centre in Taiwan. Pain intensity and pain interference were measured by items from the Bodily Pain scale of the Medical Outcomes Study Short Form-36, Taiwan version. Quality of life dimensions were measured by all instrument scales, except bodily pain. RESULTS: Moderate to severe pain was reported by 41.3% and 24(.)8% of subjects at one and 12 months following discharge, respectively. Pain interference with life was reported as quite a bit or extreme by 31.1% of subjects at 12 months after discharge. Subjects who reported moderate/severe pain at one month after discharge experienced declines in general health (p = 0.03) and vitality (p = 0.02) from 6-12 months after discharge. CONCLUSIONS: Around a quarter of hip-fractured older persons experienced moderate to very severe pain and quite a bit to severe pain interference from six months to one year after discharge. Furthermore, pain experienced during the first month after discharge significantly impacted quality of life throughout the year following discharge, even after controlling for covariates. RELEVANCE TO CLINICAL PRACTICE: Nurses must pay attention and intervene with long-term postoperative pain in hip-fractured elders to prevent further declines in physically related outcomes. The findings of this study can be used to develop effective pain-management strategies for hip-fractured older patients.