Effect of PDCA Cycle-Based Orthopedic Rehabilitation Nursing on Perioperative Pain and Functional Recovery in...

To investigate the effects of orthopedic rehabilitation nursing based on the Plan-Do-Check-Act (PDCA) cycle model on perioperative pain and postoperative functional recovery in patients undergoing surgical treatment for femoral fractures.

This retrospective single-center study included 120 patients who underwent surgical treatment for femoral fractures at The 964th Hospital of Chinese People's Liberation Army Joint Logistics Support Force between May 2023 and May 2025. Based on the nursing interventions documented in medical records, patients were assigned to a control group (n = 58) and a study group (n = 62). The control group received routine perioperative orthopedic nursing care, while the study group received PDCA cycle-based orthopedic rehabilitation nursing. Clinical outcomes compared between the two groups included time to first ambulation, length of hospital stay, perioperative pain intensity assessed using the numerical rating scale (NRS), comfort level evaluated using the general comfort questionnaire (GCQ), hip joint function assessed using the Harris Hip Score (HHS) and Functional Independence Measure (FIM), and quality of life and health-promoting lifestyle level assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and Health-Promoting Lifestyle Profile II (HPLP-II).

Compared with the control group, the study group demonstrated a significantly shorter time to first ambulation and reduced length of hospital stay (p < 0.001). Following the nursing intervention, both groups showed lower NRS scores and higher GCQ scores compared with baseline values. Furthermore, post-intervention NRS scores were significantly lower, and GCQ scores were significantly higher in the study group than the control group (p < 0.001). HHS and FIM scores improved in both groups after nursing compared with pre-nursing values, with significantly greater post-intervention scores observed in the study group (p < 0.001). Similarly, WHOQOL-BREF and HPLP-II scores increased in both groups compared with pre-nursing values, and the study group achieved significantly higher BREF and HPLP-II scores than the control group (p < 0.001).

PDCA cycle-based orthopedic rehabilitation nursing was associated with reduced perioperative pain, improved patient comfort, earlier postoperative ambulation, and enhanced functional recovery in patients with femoral fractures. However, given the retrospective single-center design and potential selection bias, the findings should be interpreted cautiously. Prospective multicenter, randomized controlled studies with larger sample sizes are warranted to validate these observations.