Knee Pain and Osteoarthritis in Older Adult

Introduction

Older adults face a mirage of health problems that is associated to their advancing age. Knee Osteoarthritis is a health complication that affects some individuals over the age of 45. The risk for knee Osteoarthritis increases as the patient advances, in the age. Osteoarthritis belongs to the category of arthritis conditions as a degenerative disease that has an effect on the daily living of the affected patient. The paper addresses knee pain and osteoarthritis as a problem that continues to affect the elderly. The paper will analyze the role of the nurses, in relation to the management of the patient. Similarly, the paper will review the HFSON conceptual framework that suits the management of osteoarthritis and knee pain.

Problem Identification

Osteoarthritis is a condition that is common among older adults. Osteoarthritis is a common type of arthritis that manifests itself through pain to joints. Osteoarthritis happens when the cartilage protecting the joint-bones wears off. The cartilage acts as a protective sheath that prevents bones from rubbing off each other. When the cartilage wears off, an individual begins to experience joint stiffness and pain. The severity of osteoarthritis depends on the affected joint. Osteoarthritis can affect the spine, knees, hands and hips. Knee osteoarthritis; for instance, cause a lot of pain to the individuals. The intensity of the pain can limit the mobility of the patient. Statistics indicates that the prevalence of Osteoarthritis is higher than the public knows. According to Ringdahl, & Pandit (2011) Osteoarthritis affects approximately 33.6% of persons over 65 years. Similarly, approximately 80% of patients struggling with Osteoarthritis experience movement limitation due to the pain. The majority of the patients require personal care and assistance with daily living.

Relation to HFSON conceptual Framework

The HFSON conceptual framework is based on the Myra Levine’s model that focuses on the client. In the nursing profession, the client refers to an individual, family or the community. The nurse must strive t establish how the community cooperates with the environment and how the resultant interaction results to the wellness or poor health of the client. The individual changes due to his constant interaction with the external and internal environment (Jamtvedt, & Christie, 2008). In the case of a patient with osteoarthritis and knee pain, the nurses must strive to establish ideal ways to minimize the pain levels and the development of the condition. HFSON also strives to ascertain nurses consider how the external environment affects the individuals, and the external al environment consists of the perpetual, conceptual and operations dimensions. The three environmental factors emphasize on perceived stimuli such as sound and light; conceptual dimensions such as beliefs, language and judgment. Additionally, operational dimensions focus on radioactivity and microorganisms (Mushtaq, & Choudhary, 2011). Osteoarthritis and knee pain intensify with movement and lessen with rest. Nurses must strive to ascertain that patients engage in minimal movement. When movement intensifies, the patients knee joints rub against each other thus resulting to continued pain. Using the HFSON framework, the nurses will strive to establish effective measures to minimize continued knee pain as a result of osteoarthritis. The nurses will strive for the conservation of the patient’s structural integrity, in relation to the management of knee pain and osteoarthritis.

Nurses can consider strategies such as mild exercise or physical therapy to minimize stiffness. Additionally, nurses can establish a weight-loss regime for the patient so as to minimize the weight-pressure to the knee (Croft, & Jordan, 2007). The patient can also receive non-steroidal anti-inflammatory drugs o decrease the pain and enhance functions. The restoration of the patient’s integrity means that the patient will have adequate defense systems that he can use to face environmental threat. In the case of a patient with osteoarthritis and knee pain, medication, exercise and therapy will ascertain that he retains his ability to move and perform simple mobile tasks (Blagojevic, & Jinks, 2010). Healthcare professionals will also strive to assist the patient to conserve his social integrity. Osteoarthritis and knee pain can affect the patient’s movement, and an individual who was once active may become immobilized and distant from the public. The ideal care will focus on assisting the patient to lead a normal; life by retaining his social relations with family and friends.

Nursing Practice roles

The care provided to patients with knee osteoarthritis aims at ascertaining that the patient is as comfortable as possible. The nurse will thus take the role of a direct caregiver. The nurse as the direct caregiver will participate in the daily life of the patient. The nurses will work with the patient, with the intention of providing advance care. Knee osteoarthritis is a degenerative disease hence its progresses and worsens with time. The nurse will provide direct care such as physical therapy (Peat, & McCarney, 2014). The nurse will also assist the patient perform simple exercises to minimize stiffness (Di Cesare, Abramson, Samuels, 2009). The nurse will also assist the patient with tasks such as personal hygiene if movement is impossible. The nurse will also be a direct caregiver who will provide medication according to the dosage provided by a physician.

The nurse will also be a teacher and counselor. The nurse will enlighten the patient as well as his immediate family on the appropriate care of his condition. The nurse will, for instance, educate the patient and his family on the appropriate sleep-rest pattern to reduce the risk of stiffness. The nurse can also counsel the patient if he is affected psychologically by the condition. Knee osteoarthritis can change an independent person to a dependent person. The patient can become depressed or stressed because of his changed lifestyle. The nurse, taking the role of the counselor can counsel the patient and give him hope (Ringdahl, & Pandit, 2011). Similarly, the nurse can help the patient establish alternative activities that he can engage in so as to retain his independence and sense of usefulness.

Potential Legal Issues

Knee pain and osteoarthritis in the older patient can be managed through effective patient care. However, healthcare providers can encounter legal constraints when they suggest a medication that the patient and his family do not wish to utilize. A healthcare provider is likely to face a lawsuit if he initiates a medical procedure that the patient and his family did not approve. Knee osteoarthritis may worsen over time making it more painful to the patient. The healthcare practitioner may alter the patient medication to a stronger dosage or a stronger type (Porcheret, & Croft, 2007). However, medications have side effects, and the patient may experience an adverse side effect as a result of the medication. It is mandatory, therefore, for the healthcare provider to weigh the benefits against the dangers of the medication they desire to provide the patient. The benefits should override the risks prior to the use of the medication.

Evidence-Based Practice (EBP)

EBP aims to integrate the best practice and treatment strategies for the provision of quality healthcare services. When considering the treatment and care for a patient with knee osteoarthritis, the main aim is to reduce joint pain and stiffness. According to Hawkeswood & Reebye (2010), healthcare professionals, can consider non-pharmacological strategies as the first option in the management of knee osteoarthritis. A non-pharmacological strategy entails the creation of awareness so that the patient can engage in self-help and patient-driven treatment strategies. Healthcare providers should provide patients with adequate information of the management of the conditions as well as the importance of changing their lifestyles. Healthcare practitioners should aim to train the patient on changes on their lifestyle, exercise, pacing of activities and the need to reduce their weight (Roddy, Zhang, Doherty, 2005). Patient-education is critical as it ascertains that the patient is part of the treatment and management process.

Conclusion

Osteoarthritis is a category of arthritis that can lead to severe pain and disability. Knee osteoarthritis affects the kneed thus making it impossible for patients to walk. Nurses should aim to restore the health and wellbeing of the patients through the adoption of effective strategies of osteoarthritis management. The healthcare providers must strive to restore the patient’s wholeness as stipulated in HFSON conceptual framework of nursing practice. The nurses will thus be direct caregivers and teachers who direct the patient on the effective strategies to minimize the pain associated with the condition. Nurses should strive to work with the patient, in relation to adopting non-pharmacological strategies of managing the condition.

Reference

Blagojevic, M. & Jinks, C. (2010). Risk factors for onset of osteoarthritis of the knee in older adults. Osteoarthritis and cartilage journal. Vol. 18(1): 24-33

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