Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery: a pilot randomised controlled trial

Cooke, M., Walker, R., Aitken, L. M., Freeman, A., Pavey, S. & Cantrill, R. (2016). Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery: a pilot randomised controlled trial. Scandinavian Journal of Caring Sciences, 30(1), pp. 74-82. doi: 10.1111/scs.12223

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Abstract

Background
Hip and knee replacement is a major surgical procedure performed worldwide. Despite 20 or so years of clinical research and care guidelines, the management of acute postoperative pain continues to be a concern. A growing number of self-efficacy strategies are being included in education programs for patients to enable then to have a central role in managing their illness and symptoms.

Aims and Objectives
The purpose of this pilot study was to evaluate the feasibility of testing an education intervention to improve self-efficacy in patients undergoing hip or knee replacement.

Methods
A single-blinded, parallel, pilot randomised control trial design was used. Ninety-one patients undergoing hip or knee replacement surgery were randomly assigned to an intervention or control group. Intervention group participants were given a DVD demonstrating self-efficacy activities to undertake four times before admission. Feasibility criteria related to recruitment, protocol adherence and missing data were assessed. Participants were assessed for pain, anxiety, self-efficacy and healthcare utilisation.

Results
In relation to recruitment, 55% of screened patients were eligible and of these 81% enrolled (n = 91). Exclusion following randomisation was 10% with missing data ranging from 0 to 20.7%. Nineteen per cent of participants were lost to follow up in the control group and 20% lost to follow up in DVD group. Protocol adherence to components of the intervention varied. Both groups were generally satisfied with pain management during hospitalisation, and there were no differences in groups on clinical outcome measures.

Conclusions
Preliminary evidence for the benefits of self-efficacy-based education for patients undergoing hip or knee replacement was identified. Additional findings included a need to strengthen the intervention and reducing the number of data collection points to improve the protocol, missing data and numbers lost to follow up before a larger trial is undertaken.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Scand J Caring Sci; 2016; 30; 74–82 Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery: a pilot randomised controlled trial, which has been published in final form at http://dx.doi.org/10.1111/scs.12223. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: pre-operative self-efficacy; pain management; hip/ knee replacement
Subjects: R Medicine > RD Surgery
R Medicine > RT Nursing
Divisions: School of Health Sciences > Department of Adult Nursing
URI: http://openaccess.city.ac.uk/id/eprint/15635

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