title: Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery: a pilot randomised controlled trial.
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.
  
  
  OBJECTIVE
  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.
authors: NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Brisbane, Qld, Australia.
authors: Marie
authors: M
authors: Cooke
authors: NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Brisbane, Qld, Australia.
authors: Rachel
authors: R
authors: Walker
authors: NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Brisbane, Qld, Australia.|Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Qld, Australia.
authors: Leanne M
authors: LM
authors: Aitken
authors: Acute Pain Service, The Queen Elizabeth II Jubilee Hospital, Brisbane, Qld, Australia.
authors: Andrea
authors: A
authors: Freeman
authors: Acute Pain Service, Gold Coast Hospital and Health Service District, Gold Coast, Qld, Australia.
authors: Sharlene
authors: S
authors: Pavey
authors: NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Brisbane, Qld, Australia.
authors: Ruth
authors: R
authors: Cantrill
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D057234:Preoperative Period; D020377:Self Efficacy
keywords: hip/knee replacement; pain management; pre-operative self-efficacy