title: Telephone Follow-Up by Nurse After Total Knee Arthroplasty: Results of a Randomized Clinical Trial.
abstract: OBJECTIVE
  Because of shorter hospitalizations, patients now have to take responsibility for their recovery period at a very early stage. We evaluated the effects of structured, nurse-managed telephone follow-up (TFU) after discharge from the hospital following total knee arthroplasty (TKA).
  
  
  METHODS
  The design was a single-center, unblinded, parallel-group randomized clinical trial. The primary outcome was self-reported physical function according to the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Secondary outcomes were stiffness and pain according to the WOMAC Index; health-related quality of life, measured with the Medical Outcomes Study Short Form (SF-36); general self-efficacy, measured with the General Self-Efficacy Scale; and number of acute visits to the orthopaedic outpatient clinic. In total, 117 patients were randomized to 2 groups: an intervention group receiving TFU 4 and 14 days after discharge in addition to conventional treatment, and a control group receiving conventional treatment. The TFUs were structured by key subjects for health status, as defined by the VIPS model (the Swedish acronym for the concepts of Well-being, Integrity, Prevention, and Safety). The effect was measured 1 and 3 months postsurgery.
  
  
  RESULTS
  No significant effects on physical function in the disease-specific WOMAC Index were identified. However, significant differences in scores were identified in favor of the intervention group on general self-efficacy (p = .014) and physical function (p = .031), measured with the Medical Outcomes Study Short Form 1 month after TKA, but this effect was not seen at 3 months. A positive improvement in several dimensions of health status and health-related quality of life was identified in favor of the intervention group, but patients who had TFU had more unscheduled visits to the outpatient clinic.
  
  
  CONCLUSIONS
  Telephone follow-up did not improve physical function compared with conventional treatment, as measured with the WOMAC Index. A short-term effect was identified, improving general self-efficacy and physical function as dimensions of health-related quality of life.
authors.affiliation: Kirsten Szöts, MScN, PhD Student, Department of Orthopedic Surgery, Gentofte University Hospital, Hellerup, Denmark; and Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. Hanne Konradsen, PhD, Research Manager, Research Unit, Gentofte University Hospital, Hellerup, Denmark. Søren Solgaard, MD, DMSc, Surgeon, Department of Orthopedic Surgery, Gentofte University Hospital, Hellerup, Denmark. Birte Østergaard, PhD, Associate Professor, Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; and OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Szöts
authors.forename: Hanne
authors.initials: H
authors.lastname: Konradsen
authors.forename: Søren
authors.initials: S
authors.lastname: Solgaard
authors.forename: Birte
authors.initials: B
authors.lastname: Østergaard
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000451:nursing*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D007719:Knee Joint; D008297:Male; D010146:Pain; D020377:Self Efficacy; D011795:Surveys and Questionnaires