Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement
surgery: a pilot randomised controlled trial
Sammanfattning
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. Published by arrangement with
John Wiley & Sons.