Osteoarthritis is a case of hip, spine and forearm fractures and injuries which is predominantly found in older people, unless otherwise. There is an increase in these fractures, injuries, morbidity and mortality rates in older people. In the 1990s, these numbered around 1.7 million worldwide and with rapid increases in the years that followed, it has been estimated around 8.2 million cases by 2050 (Cooper, 2006). Yaban (2006) made the staggering conclusion that 95% of hip fractures or injuries in old age people are caused by falls. Supporting these views, Arinzon (2007) went a little further by stating that post hip fracture disability among patients that initially survived hospitalisation is between 32-80% and that those in need of long term caring by skilled Nurses is 6-60%.
MeeK et al (2002) and Abudu et al (2002) noted the series of complications that usually develop in patients after hip fracture or injury due to old age and that 10-35% of such patients died within the first year after an injury and 30% do suffer another fracture within a year. Mitigating these appalling problems, surgery is usually recommended for a total hip replacement (THR), especially in primary and secondary Osteoarthritis. Following surgery, many patients encountered problems, especially in their activities of daily life (ADL) as they are no longer able to climb chairs, lie down in bed, and get on and off transportation without the help of someone. As a result of this dependency, after discharge, total hip replacement patients need a proper arrangement of their home settings.
The home setting is in conjunction with their new model of living (TML), which Roper in 1976 defined as those activities of living performed by individuals and care being provided throughout their lives. As Murphy et al (2002) admonished, the model did not only emphasis on individualism but also facilitates the planning of the care as a whole and the achievement of realistic and accessible goals in care.
Holistic assessment of Ms Jane.
On admission to the ward, Ms Sutcliffe is given a thorough assessment that involves the collection of her data regarding age, sex, chronic medical conditions, pre-fracture functional status, her type of fracture and operation, weight, pain perception and cognitive status. The assessment takes into account her psychological, physical and social preparation as all will play a major role in her recovery after surgery.
The psychological assessment/preparation allows her to understand what she will experience during the acute phase of the surgery and during the process of recovery. This gives her ample time to prepare ahead and come to terms with whatever follows. Banduru (1997) made mentioned of self-efficacy beliefs, which are making exercises in order to achieve good outcome after surgery. There is also the provision of verbal and written information by Nurses to her before the surgery.
Ayers et al (2004) regards physical preparation as a major life event and affects the outcome of the operation. This process underscores the point that patients that are more depressed before the surgery to have poorer pain relief after operation. On the other hand, Holman (2005)maintained patients with positive expectations before a hip operation have better physical outcomes and that those that work hard help the multidisciplinary team in achieving such outcomes.