BAB III

JURNAL

Fractured Patient’s Knowledge Regarding Care and

Treatment
Swati Kambli
Principal, Dr. D.Y. Patil College of Nursing, Maharashtra, India

Abstract: Fifty consecutive patients of bounded to injure the surrounding soft

fracture attending in and outpatient services at tissues like muscle,
Dr. D.Y. Patil Hospital and Research, Nerul, ligaments etc.
Navi Mumbai were interviewed using Hence, fracture is a break in the surface of
questionnaire to determine how well informed the bone, either
they are about their disease. Methodology: A
across to its cortex or through its articular
crosssectional
surface[1].
survey was conducted through questionnaire
regarding definition, classification, causes, Orthopaedic fractures are a common daily
clinical manifestation, complication, acute health issue.
care and emergency management of fracture. Improper initial management of fractures
Findings- majority of patients had, awareness can lead to
of home care, emergency care, dietary care significant long-term morbidity and,
in context to fracture. Conclusion- Sincere and potentially,
sustained efforts are required to impart health mortality[2]. With the burden of
education to the patients and help them to musculoskeletal disease at
participate in the self-management plans for the forefront of health care worldwide, the
fracture. World Health
Keywords: knowledge, treatment, care, Organization (WHO) declared 2000-2010
patient, fracture.
the Bone and Joint
1.Introduction Decade. The focus on orthopaedic health has
Bone has developed its own mechanism continued, with
towards the the WHO most recently declaring a “Decade
unnatural forces and keeps itself intact. But of Action for
only when the Road Safety 2011-2020,” recognizing that
force is too large and occurs suddenly (as in death and
road traffic disability from traffic trauma is a major
accidents, falls, etc.) or when a force is public health issue
chronic and worldwide.
repetitive (e.g. prolonged standing as in a
policeman, nurse
2.Need of Study
Fracture incidence is multifactorial and often
etc.) or when the natural resistance of the
complicated by
bone is eroded by a
such factors as the patient's age, sex, co-
disease process (e.g.; tumour, infection etc.)
morbidities,
than a bone
lifestyle, physiological status, and
succumbs to the insult and breaks, When it
occupation. In the United
breaks, it is
States, 5.6 million fractures occur each year,
corresponding
to a 2% incidence[3]. Almost 6000 fractures an orthopaedic trauma unit in Edinburgh,
were treated in Scotland, in one
year. The overall fracture incidence in the In this study the literature review is
Scottish case presented under the
series was 1.13% in men and 1.16% in following headings
women. Interestingly, 3.1 Knowledge regarding fracture
there was a bimodal distribution of fractures A descriptive study was conducted on
in males, with a women’s knowledge
high incidence in young men and a second on fracture at USA, 247 people aged
rise in men between 22 to 70 years
starting at the age of 60 years. In women, were selected, and data were collected by
there was a participants’
unimodal distribution of fractures, with a responses to questions. They responded to
rise around the questions about
time of menopause. self-care practices related to risk factors and
India hobbles to second place in hip preventive
fractures with 4.4 lakh behavior associated with fracture. The
people falling prey every year. Currently, results of the study
India has showed that the majority of participants had
approximately 26 million osteoporosis inadequate
patients which is knowledge regarding risk factors and
expected to reach 36 million by 2013. preventive measures of
Indians have been fracture[4]
found to have about 15 per cent lower bone A descriptive study was conducted on life-
density and it style factors for
puts us at a greater risk of broken bones promoting bone health in osteoporosis in
compared to older women at
Caucasians. UK. 320 women aged 50 years were
An experimental study was conducted on selected. Data were
osteoporosis for collected by postal questionnaire and
women in India. The study included 188 telephone
women aged 60 interviews. The results of the study showed
years and older. The data was collected by that, 92.5 per
using checklist cent of women were non-smoker, had no
and questionnaire, one group pretest and alcohol problems
post test design and participants in regular weight bearing
was used. The results of the study showed exercises, and
the intent to 21.2 per cent women changed their diet
increase calcium in their diet. Study following
recommended that identification of risk of osteoporosis[5].
nurses need to plan educational programs in A descriptive survey was conducted to
all settings to assess knowledge
teach women about the risk factors, and practices in general population
prevention, diagnosis, regarding the prevention
and treatment of osteoporosis[3] and treatment of fracture at Canada, A
3.Review of Literature convenience sample
of 185 were selected for the study. Measures culture expanded, bone marrow derived
of knowledge MSC’s in platelet
and practices were obtained by using a lysate to enhance fracture repair in
hand-delivered recalcitrant stable nonunion
questionnaire, the results of the study cases. The results of this study support the
showed that women hypothesis
received inadequate information about that autologous MSC’s delivered via
osteoporosis, percutaneous reimplantation
possessed limited knowledge about the may be an alternative modality for the
disease and were not nonoperative
taking adequate measures to prevent or treat treatment of recalcitrant non-union
fracture as they fractures[6].
age. A study was conducted to assess vitamin D
A study was conducted on Percutaneous nutrition status
Treatment of Non- in Asian-Indian patients with fragility hip
Union Fractures with Autologous, Culture fracture. The study
Expanded, Bone subjects included patients with non-
Marrow Derived, Mesenchymal Stem Cells traumatic hip fracture
and Platelet with age more than 50 years. Final analysis
Lysate. They evaluated 6 consecutive included 43
patients with chronic patients, 9 men (20.9%) and 34 women
fracture non-unions. Patients consisted of 4 (79.0%, all
women and 2 postmenopausal). Out of total 43 patients, 26
men with treatment intervention at an patients/families could be contacted, 11
average of 8.75 (42.3%) died within
months post-fracture (range 4- 18 months, one year of surgery, of which 8 patients died
one patient within first 6
fracture not included in calculation was months after surgery. Two patients died
>100 mo.). All within 72 hours
treated patients received autologous, culture after discharge from hospital. Of 15 patients
expanded, alive one year
mesenchymal stem cells injected after surgery, two were able to walk without
percutaneously via any support
fluoroscopic guidance into the site of the while 13 were able to walk with some
fracture non-union. support (stick or
Fracture union was evaluated with the use of walker).The study shows very high
follow up highresolution prevalence (96.7%) of
x-ray and/or CT imaging. Phenotype of the vitamin D deficiency in Asian-Indian
culture-expanded MSCs was evaluated and patients with fragility
quantified by hip fracture. The BMD of these patients is
flow cytometry of surface antigens. The significantly low
purpose of this in comparison to age and sex matched
study is to investigate the feasibility of a less healthy controls.
invasive, More fractures occurred at home than
percutaneous approach for the outside, with a
reimplantation of autologous majority of fall being in the bathroom [7].
Studies show that families routinely request learner can educate himself at his own pace
information on and it also
basic facts about mental illness and its stresses on rereading [13]
treatment, behavior 4.Methodology of Research
management skills, and the mental health Research methodology involves the
system in order to systematic procedure by
better cope with their relatives' illness. It is the researcher which starts from the initial
well recognized identification of
that the maximum impact of a psychiatric programme to its final conclusion [11].
disorder is borne a) Research design:
by the family and often leads to a complete A descriptive study was adopted for the
disruption in its study. Survey
functioning [8]. Patients had always stressed was carried out for purpose of providing an
about the role accurate
reversal with spouse and had also always the portrayal of a group of subjects with specific
stress about the characteristics. This study is intended to
role reversal with children. Sometimes stress ascertain the
of changes in knowledge of patients regarding fracture.
family responsibility [9]. b) Dependent variable:
Knowledge of attitudes and their functioning In this study, the dependent variable is the
is of interest knowledge
both theoretically and practically. No theory regarding fracture.
of social c) Extraneous variable:
behaviour can be complete without In this study, the extraneous variables are
incorporation of attitude age, gender,
functioning, and it is doubtful that complex educational status and duration of illness.
social behaviour d) Setting of the study:
can be predicted without knowledge of The setting of the study is at Dr. D.Y.Patil,
attitude. To study Hospital and
attitudes requires that they be measured [12] research centre, Nerul, Navi Mumbai.
Learning is the addition of new knowledge e) Population:
and experience Patients attending orthopaedic OPD and in-
Interpreted in the light of past knowledge patients in
and experience. orthopaedic ward in the age group of 12-
Teaching and learning is an integral part of 50years and
nursing. Nurses above.
have the responsibility to educate patients f) Sample:
related to various The sample for this study composed of 50
aspects and keep themselves updated. fractured
Various teaching patients in the age group 12 -50 years and
strategies are used to increase knowledge, above.
such as lecturing, g) Sampling technique:
demonstration, discussion and self- Purposive sampling technique was used to
education. These methods select the
of self-education has an advantage over the samples.
others as the Inclusion criteria for sampling:
 Age considered is from 12 years to 50 The maximum number in religion is 38
years and above. which belong to
 Willingness of patient is considered. Hindu and the minimum number is 2 which
Exclusion criteria for sampling: belong to the
 Patient who are not willing. others. The maximum number in marital
 Age group below 12 years. status is 37 which
Tool: belong to married and the minimum number
Section 1: Baseline proforma is 1 which
It consisted of 8 items namely, age, sex, belongs to divorce. The maximum number
religion, marital of personal habits
status, personal habits, educational status, is 30 in tobacco and pan chewing and the
occupational and minimum is 2 in
socioeconomic status. none of the personal habits.
Section 2: Structured knowledge The maximum number in educational status,
questionnaire 28 belong to
Structured knowledge questionnaire secondary and the minimum number is 4 in
consisted of 28 items illiterate. The
covering 5 aspects on fracture. The areas maximum number in occupational status is
included were 27 which belong
definition, etiology, clinical manifestation, to industrial and minimum number is 3
investigation, which belong to
treatment, diet, exercise, medication, home unemployed group. The maximum number
and emergency in socioeconomic
management. The items were of multiple- status is 7 which belongs to Rs,5000 to
choice type with Rs,10000/-
one correct answer. ; and the minimum number is 5 which
Plan for data analysis: belongs to Rs,10000/-
The data obtained in this study was entered 5.2 Section 2: Knowledge Level regarding
into a master fracture
data sheet prepared by the investigator to Out of 50 fractured patients, maximum
analyse the data. patients that is 96%
The data would be analysed based on the had responded correctly to- definition of
objective and fracture, preferred
hypotheses using descriptive and inferential treatment, and necessity of hospitalisation.
statistics. Also maximum
5.Major findings of the study number of patients i.e.; 96% are not aware
5.1 Section 1: Sample Characteristics about different
The maximum group belongs to the age type of fractures. Whereas the minimum
group of 31-50 numbers of patients
years ie; 60% and the minimum number i.e.; 12% have responded incorrectly to- the
belongs to the age time required for
group of 12-20 years ie; 46%. The bone healing. . Findings were contradicts
maximum number of with previous
sample is female; 54% as compared to male studies [10].
i.e; 46% Out of 50 fracture patients, maximum
number of patient
ie.68% have knowledge about taking millennium. More studies are needed to
immediate step during bring out an
fracture and the minimum number of patient effective preventive intervention. The
i.e. 48% have findings of the present
knowledge of actions to be avoided study may be helpful for such future studies.
immediately after In this context
fracture. Out of 50 fractured patients, i.e.; the findings of the study has valuable
100% are aware of implications towards
importance of exercise, whereas minimum nursing education, administration, and
number of research.
patients i.e.; 76% know the importance of Nursing Education
engaging in The health care delivery system at present is
weight bearing and strengthening exercise. giving more
Out of 50 emphasis on the preventive rather than the
fractured patients the maximum numbers of curative aspect.
patients i.e.; The nursing curriculum should incorporate
96% have knowledge about management of activities like
prior care at preparation of booklets, handouts,
home after hospitalization and the minimum pamphlets, and self
number of teaching materials for the patients to carry
patients i.e.; 72% had poor knowledge about home for further
diet to be reference. In-service education should be
followed at home. Out of 50 fractured conducted to
patients, maximum improve the knowledge and skill of
number of patients i.e.;52% have knowledge healthcare professionals.
about signs and Nursing students should be prepared to and
symptoms of infection and the minimum motivated to
number of patients conduct health teaching programmes.
i.e.; 12% had the knowledge about The study also implies that health personnel
complications of skin have to be
traction. The overall knowledge of the properly trained on how to prepare
fractured patient information booklets to
comes under range of good (19-24) i.e. 57%. teach the public regarding fracture. The
6.Conclusion information booklet
As the research project came to an end, developed can be used for educating nursing
awareness among students and
samples in relation to fracture and its health workers to equip them with necessary
management is good. knowledge and
Awareness among the patients about fracture to educate community regarding Fracture.
is the master The nursing students should be made aware
key to reduce the global burden and improve of their
the quality of responsibility in the prevention of fracture.
life of the people with fracture. Nurses can
conduct health camps, Research and
7.Scope of Study teaching on prevention
Fracture has been occurring worldwide as
we enter the new
of Fracture. The traditional system of magazines, television, and the internet.
nursing education Adequate
considers nursing as giving care and not to administrative support may be provided to
make the patients conduct such
of family members participate. Therefore a activities. Periodic surveys should be
need is felt for conducted to find out
changing the knowledge and attitude of the prevalence or severity of fracture and
nurses towards causative factors.
helping patients and becoming their partners Nursing Research
in health care. The ultimate goal of any profession is to
Nursing Practice provide its clients
Learning is an active goal directed process with maximum, effective and efficient
transforming services. A profession
knowledge skills and values into new seeking to improve the practice of its
behavior. Nurses members and to
should carefully assess the learners, set the enhance its professional stature, strives for
teaching the continual
environment, develop good rapport and development of a relevant body of
communication and knowledge. Nurses need
maintain appropriate documentation. Nurses to engage in multidisciplinary research so
can work as a that it will help to
school health nurse to increase the improve the knowledge and by applying it,
communication. Nurses health problems
have a major role in the preventive aspect can be solved. The need of the patients with
than the curative Fracture have to
aspect. be explored to prepare effective teaching
Nursing Administration methods thereby
The findings of the study could be made use contributing to effective and quality nursing
of by health care.
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