Mind-Body Nursing for Postoperative Pain and Well-Being in Hemophilia Knee Arthroplasty.

PURPOSE: Hemophilic arthropathy is a debilitating condition characterized by recurrent hemarthroses, leading to severe joint pain and eventual need for total knee arthroplasty (TKA). Postoperative pain management in this population is highly complex as the result of inherent bleeding risks, intense perioperative anxiety, and a frequently observed "pain-fear-immobility" cycle. The growing need for holistic pain management underscores the potential of mind-body nursing interventions (MBNIs). This study aimed to evaluate the impact of an MBNI on postoperative pain intensity, analgesic consumption, and related psychological and functional outcomes in patients after hemophilia TKA.

DESIGN

A single-center retrospective observational study was conducted at Peking Union Medical College Hospital in which we reviewed electronic medical records and prospectively maintained specialist nursing logs from 2020 to 2025.

METHODS

A total of 62 male patients undergoing TKA were included and were categorized into an intervention group (n = 29, receiving MBNI including relaxation, guided imagery, and mindfulness) and a control group (n = 33, receiving routine perioperative care). Allocation to the MBNI group was determined on the basis of the primary specialist nurse's clinical workload and availability rather than patient preference. Pain was measured using the visual analog scale and opioid/nonsteroidal anti-inflammatory drug consumption, alongside assessments for anxiety (State-Trait Anxiety Inventory), depression (Hospital Anxiety and Depression Scale), and functional recovery.

RESULTS

Baseline characteristics and preoperative pain levels were comparable between groups. Postoperatively, the MBNI group showed lower resting pain (visual analog scale at postoperative day 1: 3.2 ± 0.9 vs. 4.6 ± 1.1) and activity-related pain (4.8 ± 1.2 vs. 6.3 ± 1.4) and lower cumulative analgesic consumption (185.4 ± 32.6 vs. 238.2 ± 45.1 mg oral morphine equivalents; all p < .001) compared with the control group. Furthermore, the intervention group showed greater improvement in anxiety (State-Trait Anxiety Inventory at discharge: 38.5 ± 5.2 vs. 47.6 ± 6.4), sleep quality (Pittsburgh Sleep Quality Index: 5.4 ± 1.5 vs. 7.9 ± 1.8; both p < .001), and nurse-patient trust, facilitating better rehabilitation adherence without increasing bleeding complications.

CONCLUSIONS

In this retrospective cohort, MBNI was associated with lower acute postoperative pain and analgesic requirements and with improved psychological well-being in patients hemophilia with undergoing TKA.

CLINICAL IMPLICATIONS: These preliminary findings suggest that such accessible, patient-centered psychophysiological strategies warrant evaluation in a prospective randomized controlled trial before integration into routine pain management protocols for high-risk surgical populations.