The Functional Efficiency of Older Patients after Lumbar Spine Surgery, the Impact of Pain, and the Passage of Time: Tips for Care Providers
Abstract
:1. Background
2. Methods
2.1. Participants
2.2. Clinical Situation
2.3. Organization of Research
2.4. Measures
- Anonymous surveys were used to collect demographic and social data.
- Abbreviated Mental Test Score (AMTS) was used to evaluate cognitive abilities. The scoring range in this scale was from 0 to 10 points. A score below 7 points indicates the presence of cognitive disorders, and 7–10 points indicate normal cognitive functioning [17].
- Geriatric Depression Scale (GDS) used for comprehensive geriatric assessment. It helps diagnose depression in elderly people. The scoring range is 0–15. A cut-off point was proposed at which the result ≥ 5 indicates depression, and the following ranges indicates severity: 6–9 points for mild and 10–15 for moderate-to-severe depression [18].
- Barthel Index is a scale used for assessing independence in undertaking basic life activities. Interpretation: 80–100 points—independent, 60–79 points—minimally dependent, 40–59 points partially dependent, 20–39 points very dependent, <20 totally dependent [19].
- Lawton Instrumental Activities of Daily Living Scale (IADL). We used a version with 9 questions. There are 3 possible answers: 1 point means full dependence, 2 points mean partial dependence, and 3 points mean independence. Point range: 1–27 pts. The higher the points, the greater the independence.
- The Quebec Back Pain Disability Scale (QBPDS) is a tool designed to assess the degree of functional disability in people with back pain. Each of the 20 activities is scored on a scale of 0 to 5, where 0 = not difficult at all, and 5 = impossible to perform. The range is 20–100 points; and the higher the points, the less fit the person [20].
- Numerical Rating Scale (NRS). Range: 0 to 10, where 0 is no pain, and 10 is the worst pain imaginable.
- M. Rosenberg’s Self-Esteem Scale (RSES)—This scale is frequently used and recommended for assessing global self-esteem. It consists of 10 statements to which the respondent reacts by choosing one of four possible answers, according to the Likert scale ranging from 1—strongly agree—to 4—strongly disagree. The total score range for the scale is from 10 to 40 points. During analysis, the responses to positive questions need to be reversed. The general rule for evaluation is that the higher the final score, the better the self-esteem. Given the various methodological approaches to the final results (proportional assessment, distinguishing intervals with different cut-off points), the study adopted the division proposed by earlier researchers: 10–27 low; 28–31 average; >32 high [21].
2.5. Statistical Analysis
- Kruskal–Wallis test (H)—to check the significance of differences in three groups (independent samples). To precisely check the significance of the difference between pairs of groups, the Kruskal–Wallis multiple comparison test was used—a post hoc test.
- Mann–Whitney U test (U)—to check the significance of differences in two groups (independent samples).
- Friedman’s ANOVA test (X2)—to check the significance of differences in three stages (dependent samples); Dunn’s test (post hoc test) was used to more accurately check the significance of the difference between pairs of steps;
- Wilcoxon’s order of pairs test (Z)—to check the significance of differences in two stages (dependent samples);
- Spearman’s rank correlation coefficient significance test (rs)—to determine correlations between measurable variables;
- A p-value < 0.05 was considered statistically significant for all tests. The statistical package STATISTICA 10 PL was used for all calculations.
3. Results
3.1. Assessment of Mental Functioning
3.2. Self-Care Scope
3.3. The Level of Self-Esteem and Pain Intensity
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Women, N (%) | Men, N (%) | Total, N (%) |
---|---|---|---|
Sex | 69 (52.7) | 62 (47.3) | 131 (100) |
Age—mean | 69.9 ± 2.7 | 70.2 ± 30 | 70.0 ± 2.8 |
Education—number of years of education | 11.4 ± 2.6 | 11.3 ± 3.1 | 11.4 ± 2.8 |
Marital status: | |||
| 11 (15.9) | 8 (12.9) | 19 (14.5) |
| 58 (84.1) | 54 (87.1) | 112 (85.5) |
Financial situation: | |||
| 51 (73.9) | 44 (71.0) | 95 (72.5) |
| 18 (26.1) | 18 (29.0) | 36 (27.5) |
Professional activity: | |||
| 34 (49.3) | 36 (58.1) | 70 (53.4) |
| 2 (2.9) | 0 (0.0) | 2 (1.5) |
| 33 (47.8) | 26 (41.9) | 59 (45.0) |
Having a guardian: | |||
| 0 (0.0) | 0 (0.0) | 0 (0.0) |
| 69 (100.0) | 62 (100.0) | 131 (100.0) |
Stage | Place of Examination | Deadline for Conducting Research Activities | Research Tools * |
---|---|---|---|
I | Neurosurgery department | The first day after admission to the ward | AMTS, GDS, Barthel Index, IADL, QBPDS, RSES, NRS. |
II | Neurosurgery department | Day of discharge | Barthel Index, IADL, NRS, QBPDS. |
III | Neurosurgery outpatient clinic | Six weeks after surgery, during follow-up examinations | IADL, GDS, RSES, NRS, QBPDS. |
Quebec Back Pain Disability Scale | I N = 131 | III N = 131 | Z | p * | ||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | |||
1. Getting out of bed | 2.67 | 0.49 | 2.13 | 0.76 | 5.96 | <0.0001 |
2. Sleeping all night | 0.89 | 0.56 | 0.71 | 0.61 | 3.61 | 0.0003 |
3. Turning over in bed | 2.67 | 0.67 | 1.37 | 0.76 | 8.98 | <0.0001 |
4. Driving a car | 1.50 | 1.79 | 1.40 | 1.74 | 2.10 | 0.0357 |
5. Standing for 20–30 min | 4.17 | 0.53 | 3.24 | 0.64 | 8.72 | <0.0001 |
6. Sitting on a chair for a few hours | 3.78 | 0.84 | 3.37 | 0.81 | 5.09 | <0.0001 |
7. Going up one flight of stairs | 4.37 | 0.65 | 1.80 | 1.06 | 9.74 | <0.0001 |
8. Walking about 300–400 m | 3.55 | 0.79 | 1.25 | 1.12 | 9.39 | <0.0001 |
9. Walking a few kilometers | 5.00 | 0.00 | 3.75 | 0.62 | 9.62 | <0.0001 |
10. Reaching higher shelves | 5.00 | 0.00 | 4.02 | 0.40 | 9.59 | <0.0001 |
11. Throwing a ball | 5.00 | 0.00 | 3.24 | 0.81 | 9.62 | <0.0001 |
12. Running about 100 m | 5.00 | 0.00 | 4.23 | 0.46 | 8.64 | <0.0001 |
13. Taking food out of the refrigerator | 0.26 | 1.07 | 0.09 | 0.64 | 2.02 | 0.0431 |
14. Making the bed | 0.43 | 1.17 | 0.17 | 0.45 | 3.18 | 0.0015 |
15. Putting on socks | 2.42 | 0.89 | 1.11 | 0.75 | 9.02 | <0.0001 |
16. Leaning over to wash the tub | 4.98 | 0.26 | 4.02 | 0.49 | 9.55 | <0.0001 |
17. Moving a chair | 0.27 | 1.00 | 0.11 | 0.67 | 2.52 | 0.0117 |
18. Pulling or pushing heavy doors | 1.57 | 1.20 | 1.38 | 0.99 | 3.30 | 0.0010 |
19. Carrying two shopping bags | 3.57 | 0.96 | 3.19 | 0.88 | 4.66 | <0.0001 |
20. Picking up and carrying a heavy suitcase | 5.00 | 0.00 | 4.31 | 1.83 | 8.34 | <0.0001 |
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Mendyka, L.; Tobis, S.; Talarska-Kulczyk, P.; Ryszewska-Łabędzka, D.; Strugała, M.; Szewczyczak, M.; Talarska, D. The Functional Efficiency of Older Patients after Lumbar Spine Surgery, the Impact of Pain, and the Passage of Time: Tips for Care Providers. Healthcare 2024, 12, 1684. https://doi.org/10.3390/healthcare12171684
Mendyka L, Tobis S, Talarska-Kulczyk P, Ryszewska-Łabędzka D, Strugała M, Szewczyczak M, Talarska D. The Functional Efficiency of Older Patients after Lumbar Spine Surgery, the Impact of Pain, and the Passage of Time: Tips for Care Providers. Healthcare. 2024; 12(17):1684. https://doi.org/10.3390/healthcare12171684
Chicago/Turabian StyleMendyka, Luiza, Sławomir Tobis, Patrycja Talarska-Kulczyk, Dorota Ryszewska-Łabędzka, Magdalena Strugała, Marlena Szewczyczak, and Dorota Talarska. 2024. "The Functional Efficiency of Older Patients after Lumbar Spine Surgery, the Impact of Pain, and the Passage of Time: Tips for Care Providers" Healthcare 12, no. 17: 1684. https://doi.org/10.3390/healthcare12171684