The Relationship Between Perioperative Care Quality and Postoperative Comfort Level in Patients With Hip Replacement Surgery

Published:August 03, 2022DOI:



      To examine the relationship between perioperative care quality and postoperative comfort level of patients undergoing hip replacement surgery.


      This is a descriptive study.


      This study was conducted with 90 patients between February and September 2021 in a training and research hospital in Turkey. Data were collected from Information Form, the Good Perioperative Nursing Care Scale (for Patients) (GPNCS), and the Post Hip Replacement Comfort Scale (PHRCS).


      The mean age of the patients was 65.58 ± 15.10 years. The mean total scores of the patients in GPNCS and PHRCS were 134.61 ± 16.29 and 3.58 ± 0.40, respectively. In the correlation analysis, a statistically significant and positive weak relationship was determined between GPNCS and PHRCS, and as the quality of care during the surgery increases, the postoperative comfort levels increase (r = 0.253, P < .05).


      Ensuring the comfort of patients during the surgery as well as in the pre-, intra- and postoperative period is necessary and important for the quality of care. In addition, since the quality of the care during surgery is effective on the postoperative comfort levels of the patients, quality nursing care is required pre-, intra-, and postoperative periods.


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        • Büyükyılmaz F
        • Özdemir NG
        “A new life with total hip and knee replacement”: Key concepts in patient education.
        J Inonu Univ Health Services Vocational School. 2018; 6: 86-96
        • Okafor L
        • Chen AF
        Patient satisfaction and total hip arthroplasty: A review.
        Arthroplasty. 2019; 1: 1-7
        • Ulucay Ç
        • Özler T
        • Güven M
        • Akman B
        • Kocadal AO
        • Altıntaş F
        Etiology of coxarthrosis in patients with total hip replacement.
        Acta Orthop Traumatol Turc. 2013; 47: 330-333
        • Karaca A
        • Durna Z
        Patient satisfaction with the quality of nursing care.
        Nurs Open. 2019; 6: 535-545
        • Buchanan J
        • Dawkins P
        • Lindo JLM
        Satisfaction with nursing care in the emergency department of an urban hospital in the developing world: A pilot study.
        Int Emerg Nurs. 2015; 23: 218-224
        • Smith Z
        • Gillespie B
        Perioperative care.
        Clinical Nursing Skills An Australian Perspective. Cambridge University Press, Cambridge, UK2017 (Available at:)
        • Blomberg AC
        • Bisholt B
        • Lindwall L
        Responsibility for patient care in perioperative practice.
        Nurs Open. 2018; 5: 414-421
        • Johnson EC
        • Horwood J
        • Gooberman-Hill R
        Conceptualising time before surgery: The experience of patients waiting for hip replacement.
        Soc Sci Med. 2014; 116: 126-133
        • Saray Kilic H
        • Tastan S
        Development of post hip replacement comfort scale.
        Appl Nurs Res. 2017; 38: 169-174
        • Kolcaba KY
        A taxonomic structure for the concept comfort.
        J Nurs Scholarsh. 1991; 23: 237-240
        • Kolcaba K
        Comfort Theory and Practice: A Vision for Holistic Health Care and Research.
        Springer Publishing Company, New York, USA2003
        • Karaca A
        • Durna Z
        Patient satisfaction with the quality of nursing care.
        Nurs Open. 2019; 6: 535-545
        • Seyedfatemi N
        • Rafii F
        • Rezaei M
        • Kolcaba K
        Comfort and hope in the preanesthesia stage in patients undergoing surgery.
        J Peri Anesth Nurs. 2014; 29: 213-220
        • Yeşilyaprak T
        • Özşaker E
        The investigation of the patiıents’ opinions about the operating room environment.
        E-J Dokuz Eylul Univ Nurs Faculty. 2018; 11: 315-321
        • Hertel-Joergensen M
        • Abrahamsen C
        • Jensen C
        Translation, adaptation and psychometric validation of the Good Perioperative Nursing Care Scale (GPNCS) with surgical patients in perioperative care.
        Int J Orthop Trauma Nurs. 2018; 29: 41-48
        • Sevin K
        Evaluation of perioperative nursing care quality in orthopedic surgery patients.
        Master’s thesis. Hasan Kalyoncu Universty, Gaziantep, Turkey2018
        • Delgado DA
        • Lambert BS
        • Boutris N
        • et al.
        Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults.
        J Am Acad Orthop Surg Glob Res Rev. 2018; 2: e088
        • Leinonen T
        • Leino-Kilpi H
        • Jouko K
        The quality of intraoperative nursing care: The patient's perspective.
        J Adv Nurs. 1996; 24: 843-852
        • Leinonen T
        • Leino-Kilpi H
        • Stahlberg MR
        • Lertola K
        Thequality of perioperative care: Development of a tool for theperceptions of patients.
        J Adv Nurs. 2001; 35: 294-306
        • Candan Donmez Y
        • Ozbayır T
        Validity and reliability of the ‘good perioperative nursing care scale'for Turkish patients and nurses.
        J Clin Nurs. 2011; 20: 166-174
        • Karagöz Y
        SPSS 23 and AMOS 23 Applied Statistical Analysis.
        Nobel Publisher, Ankara, TX2016
        • Güner A
        • Karakoç Kumsar A
        Comfort level and factor affecting comfort level of patients who had surgery for lung cancer.
        Online Turk J Health Sci. 2021; 6: 155-162
        • Yılmaz E
        • Çeçen D
        • Toğaç HK
        • Mutlu S
        • Kara H
        • Aslan A
        The comfort levels and nursing care of patients during perioperative period.
        Manisa Celal Bayar Univ Instit Health Sc. 2018; 5: 3-9
        • Eyi S
        • Kanan N
        • Akyolcu N
        • Levhi Akın M
        • Acaroğlu R
        Evaluation of intraoperative nursing care by patients.
        TAF Prev Med Bull. 2016; 15: 159-170
        • Çevik Acar E
        • Yıldız Fındık Ü
        Thoughts about the quality of nursing care of patients in the operating room and the assessment of anxiety levels.
        J Anatolia Nursin Health Sci. 2015; 18: 268-273
        • Gurcayir D
        • Karabulut N.
        The effects of the training provided to patients who are scheduled for hip prosthesis surgery on the level of postoperative comfort and daily activities.
        Int J Caring Sci. 2017; 10: 403-413
        • Bergström A
        • Håkansson Å
        • Stomberg MW
        • Bjerså K
        Comfort theory in practice—Nurse anesthetists' comfort measures and interventions in a preoperative context.
        J Perianesth Nurs. 2018; 33: 162-171
        • Fowler SB
        • Vinson S
        • Kollstedt K
        Nurse-driven comfort interventions in the perioperative setting.
        Int J Hum Caring. 2020; 24: 237-244
        • Yaman Aktas Y
        • Karabulut N
        The association between quality of perioperative nursing care and comfort among neurosurgery patients.
        Clin Experimental Health Sci. 2020; 10: 332-337
        • Büyükünalan Şahin P
        • Rızalar S
        Perianesthesia comfort levels of the patients undergone operation and it's affecting factors.
        J Health Sci Profession. 2018; 5: 404-413
        • Yönem Amaç H
        • Çam R
        The patient comfort in day surgery patients and factors affecting the patient comfort.
        Health Sci J Adıyaman Univ. 2019; 5: 1222-1237
        • Matsen III, FA
        • Li N
        • Gao H
        • Yuan S
        • Russ SM
        • Sampson PD
        Factors affecting length of stay, readmission, and revision after shoulder arthroplasty: A population-based study.
        J Bone Joint Surg. 2015; 97: 1255-1263
        • Bogunovic L
        • Gottlieb M
        • Pashos G
        • Baca G
        • Clohisy JC
        Why do hip arthroscopy procedures fail?.
        Clin Orthop Relat Res. 2013; 471: 2523-2529
        • Arslankiliç Ç
        • Göl E
        The use of Kolcaba's comfort theory in patients undergoing surgical operation: A systematic review.
        Turkish J Health Sci Res. 2020; 3: 34-44
        • Nichols T
        Comfort as a multidimensional construct for pain management.
        Creat Nurs. 2018; 24: 88-98
        • Niyomrat W
        • Masingboon K
        • Kunsongkeit W
        Relationships between comfort and pain, anxiety, and social support in acute respiratory failure patients with non-invasive ventilator support.
        Thai Pharma Health Sci J. 2018; 13: 179-186
        • Qian H
        • Zhou J
        • Huang T
        • Cao X
        • Zhou C
        • Yang M
        • Chen Y
        Comfort nursing can alleviate pain and negative emotion of patients after surgery for LVCFs and improve their living ability.
        Am J Transl Res. 2021; 13: 2939-2946
        • Mondanaro JF
        • Homel P
        • Lonner B
        • Shepp J
        • Lichtensztejn M
        • Loewy JV
        Music therapy increases comfort and reduces pain in patients recovering from spine surgery.
        Am J Orthop. 2017; 46: 13-22
        • Chua MJ
        • Hart AJ
        • Mittal R
        • Harris IA
        • Xuan W
        • Naylor JM
        Early mobilisation after total hip or knee arthroplasty: A multicentre prospective observational study.
        PLOS One. 2017; 12e0179820
        • Ni CY
        • Wang ZH
        • Huang ZP
        • et al.
        Early enforced mobilization after liver resection: A prospective randomized controlled trial.
        Int J Surg. 2018; 54: 254-258
        • Wainwright TW
        • Gill M
        • Mcdonald DA
        • et al.
        Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations.
        Acta Orthop. 2020; 91: 3-19
        • Ripollés-Melchor J
        • Aldecoa C
        • Fernández-García R
        • et al.
        Early mobilization after total hip or knee arthroplasty: A substudy of the POWER. 2 study.
        Braz J Anesthesiol. 2021; (in press)
        • Karabulut N
        • Aktas YY
        • Gurcayır D
        • Yılmaz D
        • Gokmen V.
        Patient satisfaction with their pain management and comfort level after open heart surgery.
        Aust J Adv Nurs. 2015; 32: 16-24
        • Abdollahi AA
        • Mehranfard S
        • Behnampour N
        • Kordnejad AM
        Effect of positioning and early ambulation on coronary angiography complications: A randomized clinical trial.
        Int J Caring Sci. 2015; 4: 125-134
        • Uğurlu Ak
        • Kula Şahin S
        • Seçginli S
        • Eti Aslan F
        The effect of standing up early in the first 24 hours after surgery on rapid improvement: Systematic review.
        Turkiye Klinikleri J Nurs. 2017; 9: 280-288