Effectiveness of a Nurse-Led Bundle of Interventions in Reducing Neuropathic Pain Among Orthopedic Patients
DOI:
https://doi.org/10.53926/YNJR/0034Keywords:
neuropathic pain, bundles of intervention, DN 4 questionnaire, orthopedic patients, pain careAbstract
Background: Patients recovering from fractures and orthopedic trauma routinely endure significant discomfort, and this suffering is usually attributed entirely to the injury itself and its surgical repair. What often goes unnoticed within that discomfort is a distinct, nerve-related component burning, tingling, numbness that can develop alongside the mechanical injury but is easily overlooked when nursing attention stays focused on the fracture alone. Left unaddressed, this hidden neuropathic pain can slow rehabilitation and prolong patients' dependence on caregivers.
Objectives: To assess the level of existing neuropathic pain among orthopedic patients, to evaluate the impact of a bundle of interventions in reducing this pain, and to determine its association with selected socio-demographic variables.
Methods: A pre-experimental one-group pre-test post-test design was used among 60 orthopedic patients aged 40–60 years with neuropathic pain, admitted at GIMS Teaching Hospital, Gadag, enrolled through non-probability purposive sampling. Neuropathic pain was assessed using the standardized DN-4 questionnaire (score ≥4 indicating neuropathic pain) before and on the 7th day after implementation of a bundle of interventions patient education, non-pharmacological measures, and patient empowerment delivered three times daily for seven days. Data were analysed using descriptive statistics and the paired t-test and Chi-square test.
Results: Every participant began with clinically significant pain (mean DN-4 score 5.83, SD 0.96). By day seven, two-thirds of patients (66.7%) had dropped into the reduced-pain range, and the average score fell to 3.42 (SD 1.12) a highly significant change (paired t = 19.43, table value = 2.00, p < 0.05). Post-test pain levels were significantly associated with patients' occupation (χ² = 12.69, p < 0.05) and family income (χ² = 10.63, p < 0.05), but not with age, gender, education, or the other background factors studied.
Conclusion: A simple, nurse-led bundle combining education, non-drug techniques, and patient involvement meaningfully eased neuropathic pain in this group, suggesting it is a practical addition to routine orthopedic bedside care.
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