Type of Document	Thesis
Author	Utuk, Kimberly
Author's Email Address	Gatr2003@aol.com
URN	etd-11062006-163732
Title	A Study of the Relationships Between Pain Level, Analgesic Requirements, and Quality of Life Associated with Total Knee Arthroplasty
Degree	Master of Science
Department	Nursing, School of
Advisory Committee	Advisor Name Title James Whyte Committee Chair Laurie Grubbs Committee Member Sandra Faria Committee Member
Keywords	Roy's Adaptation Model Medication Journal Knee Replacement Narcotic NSAID
Date of Defense	2006-11-03
Availability	unrestricted
Abstract Patients suffering from various arthritic conditions such as osteoarthritis (OA) seek relief through total knee arthroplasty (TKA). The surgery itself has been proven successful; however it carries a difficult and challenging recovery period. The purpose of this study was to examine the relationships between pain levels and quality of life (QOL), and to determine the effect pain has on QOL measures pre- and post TKA. A sample of thirteen participants receiving care at a local orthopedic clinic was selected from the North Florida area via convenience sampling. Participants were asked to complete a demographic questionnaire, the Western Ontario and McMaster Universities (WOMAC) Arthritis Index, and a medication journal preoperatively, and again at six-weeks postoperatively. The WOMAC has been thoroughly tested for reliability and validity across multiple research studies. Inclusion criteria were limited to those having TKA secondary only to OA, and those subsequently entering a rehabilitation program after hospital discharge. The patients had to be able to read and understand English, and be able to communicate their pain levels through a mediation journal and the WOMAC. The hypotheses concerned the presence of a relationship between pain and QOL measures pre- and postoperatively. Paired samples t-test and Pearson’s Correlational analyses were used to examine potential relationships. As a result of the collected data, there were significant relationships between preoperative pain levels and WOMAC scores (r = .814, p = .001), preoperative and postoperative pain levels (t = 4.177, p = .001), postoperative pain levels and WOMAC scores (r = .903, p = .000), and preoperative and postoperative WOMAC scores (t = 5.378, p = .000). Medication journaling did not provide sufficient data to infer to the general orthopedic population. Overall, decreases in postoperative pain levels correlated with decreases in total WOMAC scores, signifying improvements in pain and QOL. Based on these results, it is the responsibility of the advanced practice nurse to accurately assess pain and its impact on QOL in this population of OA sufferers. The integration of the WOMAC in pain assessment may help assist in tailoring effective pain management regimens during the course of TKA.
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