Self-management in patients with adult spinal deformity: a best practice implementation project

Introduction: The prevalence of adult spinal deformity (ASD) has increased in recent years. Patients often have to live for a prolonged period from the onset of the condition, up until the need for surgical treatment. Self-management plays a crucial role in disease progression and prognosis. Objectives: This project aimed to promote evidence-based practices for the self-management of patients with ASD. Methods: This project was guided by the JBI Evidence Implementation Framework project and was conducted in the orthopedic department of a tertiary care hospital in China. A baseline audit was conducted to evaluate current practice against best practice recommendations. Barriers were identified and, after the implementation of improvement strategies, a follow-up audit was conducted to assess project effectiveness. Results: A comparison between the baseline and follow-up audits revealed a significant increase in nurses' compliance with best practices (rising from 0%-64% to 97.7%-100%) in the following areas: improved health promotion behaviors by nurses in self-management of ASD patients; acquisition and application of communication skills with patients; increased availability of educational materials in the ward; and establishment of conservative treatment follow-up instructions for patients. For patients, the Visual Analog Scale of pain decreased from (2.72 +/- 1.67) to (1.90 +/- 1.14), the Oswestry Disability Index decreased from (49.96 +/- 16.49) to (39.83 +/- 18.97), self-management behaviors improved from (10.84 +/- 4.31) to (19.52 +/- 6.31), and maximum isometric muscle strength in the standing position increased from (179.48 +/- 91.18)N to (250.03 +/- 91.50)N, all with statistically significant improvements (p <0.05). For nurses, the knowledge questionnaire score improved from (34.83 +/- 24.16) to (82.00 +/- 11.11) (p <0.05). Conclusions: This project helped ASD patients improve self-management, alleviated their clinical symptoms, and improved nurses' knowledge of best practices. Future audits will be conducted to review long-term project outcomes.