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A pilot study to develop a non-
pharmacology nursing intervention, to
reduce pain in patients receiving total
knee arthroplasty
Gloria Greβ
Claudia Sousa Oliveira
Catharina van Oostveen
Foundation for Healthcare
Improvement Research
Tarja Poikkeus
Connie Lethin
Maren Falch Lindberg
The European Academy of Nursing Science 2
Evidence Base
Systematic Review
58% of the patients has moderate to
severe pain after surgery
Delay rehabilitation, compliations Wylde et al.(2011) Ranawat, A. S., Ranawat, C. S. (2007)
Question: What is the effect of a complex non-pharmacologal
nursing intervention]I for pain management]O for [patients
receiving total knee arthroplasty]P
Preoperative information about pain
Cold therapy
Music therapy Fletcher et al 2008; Kwan et al 2011; Cepeda et al 2009
The European Academy of Nursing Science 3
Theory: Three Dimensions of Pain
PAIN
R. Melzack & K. Casey (1968)
Sensory
Emotional
Cognitive
Patient experience
Non-pharmalogical I.
Predictive Factors
The European Academy of Nursing Science 4
Methods
PHASE I
INT
ER
VE
NT
IONSystematic Review
Systematic Review
Qualitative Study
Sensory
Emotional
Cognitive
1. Before Surgery – Training2. During Surgery – Music Therapy3. After Surgery – Cold Therapy
The European Academy of Nursing Science 5
Feasibility/Piloting
PHASE II
1. Focus group interview, nurses2. Interview patients3. Observe the intervention4. Diary
Outcomes
1. Pain intensity2. Opioid consumption 3. Length of stay4. Re-admission5. Costs per patients
Inclusion process
Intervention 10 pp
UC 10 pp
RR
Economic evaluation
The European Academy of Nursing Science 6
Estimated expences Eur
Personell costs 900
Material costs 4100
Salary phd student, 1 year 60000
Sum 65000
A pilot study to develop a non-
pharmacology nursing intervention, to
reduce pain in patients receiving total
knee arthroplasty
Gloria Greβ
Claudia Sousa Oliveira
Catharina van Oostveen
Foundation for Healthcare
Improvement Research
Tarja Poikkeus
Connie Lethin
Maren Falch Lindberg