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The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement

The perioperative care of patients undergoing total knee arthroplasty (TKA) affects functional recovery and clinical outcomes. This study aims to introduce a patient-specific integrated education program (IEP) into the TKA clinical pathway and to evaluate patient outcomes between the intervention an...

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Autores principales: Ho, Cheng-Jung, Chen, Yen-Ti, Wu, Hung-Lan, Huang, Hsuan-Ti, Lin, Sung-Yen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146256/
https://www.ncbi.nlm.nih.gov/pubmed/35629142
http://dx.doi.org/10.3390/jpm12050719
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author Ho, Cheng-Jung
Chen, Yen-Ti
Wu, Hung-Lan
Huang, Hsuan-Ti
Lin, Sung-Yen
author_facet Ho, Cheng-Jung
Chen, Yen-Ti
Wu, Hung-Lan
Huang, Hsuan-Ti
Lin, Sung-Yen
author_sort Ho, Cheng-Jung
collection PubMed
description The perioperative care of patients undergoing total knee arthroplasty (TKA) affects functional recovery and clinical outcomes. This study aims to introduce a patient-specific integrated education program (IEP) into the TKA clinical pathway and to evaluate patient outcomes between the intervention and control groups. We performed a two-site, two-arm, parallel-prospective controlled trial. The experiment group received an IEP incorporating verbal preoperative education, prehabilitation, multidisciplinary personalized rehabilitation during hospitalization, and supervised self-executed home-based exercise after discharge. The control group received regular TKA clinical care. We monitored the pain intensity, anxiety scores, and functional scores at six time points from the pre-operation interview to 3 months post-operation. The pain score was significantly decreased in the IEP group during hospitalization (p < 0.01) and before discharge (p < 0.05). The anxiety status was also improved after intervention in terms of state and trait anxiety inventory scores (p < 0.001) during hospitalization. The patient-reported (WOMAC) or physician-reported (American Knee Society Score) functional scores (p < 0.01 at most of the time points) all improved significantly under hospitalization. We found that the patient-specific IEP combining preoperative education, prehabilitation, the in-hospital group education class, and postoperative care navigation is effective in reducing postoperative pain, decreasing perioperative anxiety, and facilitating functional recovery following TKA.
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spelling pubmed-91462562022-05-29 The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement Ho, Cheng-Jung Chen, Yen-Ti Wu, Hung-Lan Huang, Hsuan-Ti Lin, Sung-Yen J Pers Med Article The perioperative care of patients undergoing total knee arthroplasty (TKA) affects functional recovery and clinical outcomes. This study aims to introduce a patient-specific integrated education program (IEP) into the TKA clinical pathway and to evaluate patient outcomes between the intervention and control groups. We performed a two-site, two-arm, parallel-prospective controlled trial. The experiment group received an IEP incorporating verbal preoperative education, prehabilitation, multidisciplinary personalized rehabilitation during hospitalization, and supervised self-executed home-based exercise after discharge. The control group received regular TKA clinical care. We monitored the pain intensity, anxiety scores, and functional scores at six time points from the pre-operation interview to 3 months post-operation. The pain score was significantly decreased in the IEP group during hospitalization (p < 0.01) and before discharge (p < 0.05). The anxiety status was also improved after intervention in terms of state and trait anxiety inventory scores (p < 0.001) during hospitalization. The patient-reported (WOMAC) or physician-reported (American Knee Society Score) functional scores (p < 0.01 at most of the time points) all improved significantly under hospitalization. We found that the patient-specific IEP combining preoperative education, prehabilitation, the in-hospital group education class, and postoperative care navigation is effective in reducing postoperative pain, decreasing perioperative anxiety, and facilitating functional recovery following TKA. MDPI 2022-04-29 /pmc/articles/PMC9146256/ /pubmed/35629142 http://dx.doi.org/10.3390/jpm12050719 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ho, Cheng-Jung
Chen, Yen-Ti
Wu, Hung-Lan
Huang, Hsuan-Ti
Lin, Sung-Yen
The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement
title The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement
title_full The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement
title_fullStr The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement
title_full_unstemmed The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement
title_short The Effects of a Patient-Specific Integrated Education Program on Pain, Perioperative Anxiety, and Functional Recovery following Total Knee Replacement
title_sort effects of a patient-specific integrated education program on pain, perioperative anxiety, and functional recovery following total knee replacement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146256/
https://www.ncbi.nlm.nih.gov/pubmed/35629142
http://dx.doi.org/10.3390/jpm12050719
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