การพัฒนาโปรแกรมการส่งเสริมการฟื้นตัวภายหลังผ่าตัดสำหรับผู้ป่วยที่เข้ารับการผ่าตัดดามกระดูกข้อสะโพก โรงพยาบาลสมเด็จพระยุพราชเดชอุดม

Chantip  Buawat; Teepatad Chintapanyakun; Watcharaphan  Wongkhamphan; Suwimon  Kheiwkham; Adisak  Prawitthana; Benjawan  Prajamtin

Authors

Chantip Buawat Nursing Division, Detudom Crown Prince Hospital
Teepatad Chintapanyakun Department of Nursing Service, Ramathibodi Hospital, Mahidol University
Watcharaphan Wongkhamphan Nursing Division, Detudom Crown Prince Hospital
Suwimon Kheiwkham Nursing Division, Detudom Crown Prince Hospital
Adisak Prawitthana Orthopaedic Surgery Division, Detudom Crown Prince Hospital
Benjawan Prajamtin Rehabilitation Medicine Division, Detudom Crown Prince Hospital

Keywords:

enhanced recovery after surgery (ERAS) program, hip internal fixation surgery

Abstract

This research and development study aimed to develop an Enhanced Recovery After Surgery (ERAS) program for patients undergoing hip internal fixation and to compare clinical and hospital outcomes between the experimental and control groups. The sample consisted of 62 patients with hip fractures who underwent internal fixation surgery in the orthopedic ward of Detudom Crown Prince Hospital. Participants were purposively selected and divided into two groups: 31 patients in the experimental group who received the ERAS program and 31 patients in the control group who received standard nursing care. Research instruments included the ERAS program for hip internal fixation surgery, a personal and treatment information questionnaire, a pain assessment form, and a hip range of motion (ROM) recording sheet. Data were analyzed using descriptive statistics and the Mann-Whitney U test.

The findings were as follows: 1) The ERAS program for patients undergoing hip internal fixation surgery demonstrated strong content validity, with a content validity index (CVI) ranging from .90 to 1.00, indicating academic soundness and likely safety for implementation. 2) Regarding clinical outcomes, the median pain score at 72 hours postoperatively was significantly lower in the experimental group than in the control group (p < .05). Although pain scores at 24 and 48 postoperative hours differed between groups, the differences were not statistically significant. The experimental group also showed significantly greater hip ROM-flexion, extension, and abduction-compared to the control group (p < .05). 3) In terms of hospital outcomes, the median length of stay and hospitalization costs were significantly lower in the experimental group compared to the control group (p < .05).

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