Determining the Factors Affecting Fear of Movement in Patients Undergoing Total Knee Replacement

Yıl 2025, Cilt: 8 Sayı: 1, 39 - 50, 05.04.2025

Nihal Yıldız Emre , Mevlüde Karadağ

https://doi.org/10.38108/ouhcd.1399561

Öz

Objective: Total knee replacement (TKR) negatively affects the recovery process because TKR patients avoid movement and have difficulty meeting their needs. Therefore, the aim of this study is to determine the level of fear of movement and affecting factors in patients undergoing total knee replacement surgery according to the surgery period.
Methods: The sample consisted of 150 TKR patients at a university hospital. Data were collected by using a questionnaire including sociodemographic characteristics developed by the researcher, Lysholm Knee Scoring Scale, Barthel Daily Living Activities Index, Numeric Rating Scale and Tampa Kinesiophobia Scale. Data were collected three times using the Tampa Scale of Kinesiophobia (TSK) (1) before surgery, (2) one day after surgery, and (3) three weeks after discharge. The data were analyzed using independent samples t-test, analysis of variance (ANOVA), Tukey, Tamhane, Mann-Whitney U, Kruskal-Wallis H tests, and Bonferroni correction. The statistical significance level of the study is indicated as p<0.05.
Results: Participants had a mean TSK score of 44.05±6.24, 45.54±7.05, and 42.79±8.15 before surgery, one day after surgery, and three weeks after discharge, respectively. Most participants needed help with their activities of daily living after surgery (89.3%). More than three-quarters of the participants avoided movement due to postoperative pain (78.7%). Participants who did not exercise after discharge (1,99±1,66) had higher pain levels (p=0,010) than those who did (1,32±1,38). Participants who exercised regularly (38,12±7,58) had less fear of movement (p=0,000) than those who did not (45,90±6,97).
Conclusion: Post-TKR pain and fear of movement cause patients to avoid moving, which negatively affects the recovery process. Patients who exercise regularly recover more quickly. Therefore, it is important to identify the factors affecting fear of movement in TKR patients.

Anahtar Kelimeler

total knee replacement, movement, activities of daily living, pain, orthopedic nursing

Total Diz Protezi Ameliyatı Geçiren Hastalarda Hareket Korkusunun ve Etkileyen Faktörlerin Belirlenmesi

Öz

Amaç: Total diz protezi ameliyatı sonrası ağrı, hastanın hareketten kaçınmasına ve bireysel ihtiyaçlarını karşılayamamasına neden olarak iyileşmeyi olumsuz etkiler. Bu nedenle bu çalışmanın amacı total diz protezi ameliyatı geçiren hastalarda hareket korkusu düzeyinin ve etkileyen faktörlerin ameliyat dönemlerine göre belirlenmesidir.
Yöntem: Araştırmanın örneklemine bir üniversite hastanesinde ilk kez total diz protezi ameliyatı geçirmiş 150 hasta alınmıştır. Verilerin toplanmasında araştırmacı tarafından geliştirilen tanımlayıcı özellikleri içeren soru formu, Lysholm Diz Skorlama Ölçeği, Barthel Günlük Yaşam Aktiviteleri İndeksi, Sayısal Kıyaslama Ölçeği ve Tampa Kinezyofobi Ölçeği kullanılmıştır. Veriler ameliyat öncesi, ameliyat sonrası birinci günde ve taburculuk sonrası üçüncü haftada toplanmıştır. İstatistiksel analizde Independent Sample-t, ANOVA, Tukey, Tamhane, Mann-Whitney U, Kruskal-Wallis H testleri ve Bonferroni düzeltmesi kullanılmıştır. Çalışmanın anlamlılık derecesi p<0,05 ile belirtilmiştir.
Bulgular: Çalışmaya katılan hastaların yaş ortalamasının 65,92±9,40 (yıl) ve %55,3’ünün kadın olduğu tespit edilmiştir. Hastaların Tampa Kinezyofobi Ölçeği puan ortalamaları ameliyat öncesi (44,05±6,24), ameliyat sonrası birinci günde (45,54±7,05) ve taburculuk sonrası üçüncü haftada (42,79±8,15) yüksek bulunmuştur. Hastaların %89,3’ünün ameliyat sonrası günlük yaşam aktivitelerinde yardıma ihtiyaç duyduğu, %78,7’sinin ameliyat sonrası ağrı nedeniyle hareketten kaçındıkları bulunmuştur. Taburculuk sonrası dönemde egzersiz yapmayan hastaların ağrı düzeylerinin (1,99±1,66) yapanlara (1,32±1,38) göre daha yüksek olduğu (p=0,010), düzenli egzersiz yapan hastaların hareket korkusu düzeylerinin (38,12±7,58) yapmayan hastalara (45,90±6,97) göre daha düşük olduğu saptanmıştır (p=0,000).
Sonuç: Total diz protezi ameliyatı sonrası ağrı ve hareket korkusu hastaların hareket etmekten kaçınmalarına neden olmakta ve taburculuk sonrası iyileşmeyi olumsuz etkilemektedir. Egzersiz yapan hastalarda iyileşme daha hızlı gerçekleşmektedir. Bu nedenle total diz protezi ameliyatı sürecinde hareket korkusunun ve etkileyen faktörlerin belirlenmesi önemlidir.

Anahtar Kelimeler

total diz replasmanı, hareket korkusu, günlük yaşam aktiviteleri, ağrı, ortopedi hemşireliği

Kaynakça

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