Sleep satisfaction, perceived pain and acute confusion in elderly clients undergoing orthopaedic procedures

This paper reports the results of a descriptive study of elderly subjects undergoing orthopaedic hip surgery under two qualitatively different events; planned surgery for hip replacement and unplanned emergency surgery following hip fracture. Its purpose was to describe sleep satisfaction, pain perceptions and psychological concerns of subjects undergoing similar procedures but having differential contexts for their experience and different outcomes. Delirium is a common phenomenon following orthopaedic hip surgery. The extent to which an individual's integrity is disrupted by psychological distress, pain and changes in sleep satisfaction as manifested by delirium was investigated. The results revealed that the context or nature of the experience strongly influences the perceptions of subjects despite their having undergone treatments of similar magnitude and their having received similar postoperative care. Pain was greater for unplanned surgery subjects and in particular for unplanned surgery subjects who succumbed to delirium. Sleep satisfaction was markedly poorer among subjects who experienced delirium. The findings are discussed with respect to nursing practice priorities and attitudes toward pain management.