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Patients’ education is a dynamic, integrated and multifaceted teaching-learning process in which the nurse and patient work together to change patients’ behaviors through their compliance with medical instruction. Health education is an independent function of nursing practice and a primary nursing responsibility. All nursing care is directed toward promoting, maintaining, and restoring health, preventing complications, and helping patients adapt to the residual effect of illness. Many of these nursing activities are accomplished through patients’ education.
The primary goal of knee replacement operation is to relieve pain and limitations resulting from knee disease. However, active participation in the care of patients undergoing knee replacement operation must be taken in action. Some activities will need to be modified and some may not be appropriate after knee replacement. So that, educational program for those patients may assist them to cope with changes that occur after knee replacement operation and detection malfunction through follow -up care.
Nurses in their role as teachers are challenged to focus on the educational needs of patients undergoing knee replacement operation and providing them specific health education which is important because it includes the following benefits: affects the abilities of patients and their families to perform important self- care activities, promoting their compliance and self-efficacy at home and in the community, reducing health care costs by preventing complication, decreasing lengths of hospital stay and facilitating earlier discharge.
Aim of the study:
The aim of this study was to determine the effect of educational program on compliance and self efficacy of patients undergoing knee replacement operation.
The current study hypothesized that:
The implementation of the educational program will have positive effect on compliance and self efficacy of patients undergoing knee replacement operation
A quasi experimental design was utilized to meet the aim of the study.
The study was conducted in orthopedic departments and outpatient clinics at El-Dmerdash Surgical Hospital which is affiliated to Ain Shams University Hospitals.
A purposive sample of sixty six (66) adult patients from both genders with primarily uncomplicated total or partial knee replacement operation.
I- Patients’ assessment sheet (Appendix I):
This tool aimed to assess educational needs of patients undergoing knee replacement before the implementation of the operation. It consists of three parts:
First part: concerned with patient’s demographic data.
Second part: concerned with medical history of patients.
Third part: concerned with patients’ educational needs regarding knee replacement operation.
II- Patients’ compliance assessment questionnaire (Appendix II): this tools was used to assess patients’ compliance regarding medication, joint protection, Pain management, exercises, follow up and nutrition.
III- Knee function Self efficacy scale (Appendix III): This tool modified by the researcher to assess knee replacement patients’ self-efficacy.
Results of this study showed that:
- The present study revealed that there was nonsignificant difference between number of patients who have satisfactory level of knowledge about knee replacement operation, description of artificial joint, pain management, medications, physical exercises, nutrition, follow up, management of stress and total knowledge on both groups (study and control). While, there was statistically significant difference between them regarding joint protection.
- There was significant difference between the number of compliant patients in the study and control groups three and six months post educational program regarding their compliance with pain management, joint protection, physical exercises and follow up. While, there was nonsignificant difference between the two groups regarding their compliance with medication, nutrition
- There were highly statistically significant differences between study and control groups regarding all domains of self efficacy aspects (physically, socially and psychologically) three and six months post educational program.
- There were statistically significant differences between younger and elderly patients of study group regarding compliance with pain management, physical exercises and nutrition. While there were statistically nonsignificant differences between them regarding joint protection, medication and follow up.
- There were highly statistically significant differences between younger and elderly patients of study group regarding their self efficacy with physical and psychological domains .While, there was statistically nonsignificant difference between them regarding social domain.
- There were significant differences between illiterate and educated (basic and high education) patients of study group regarding their compliance with medication, pain management and joint protection, physical exercises, follow up and nutrition.
- There were significant differences between illiterate and educated patients (basic and high education) regarding their self efficacy with physical, social and psychological domains
The results of this study concluded that:
Application of educational program regarding knee replacement operation has positive effect on improving compliance of patients after knee replacement operation regarding pain management, joint protection, physical exercises and follow up. But has no effect on compliance of patients with medications, and nutrition.
Application of educational program has positive effect on enhancing all aspects of self efficacy domains (physical, social, psychological).
The study recommended that
Replication of the current study on a larger probability sample is recommended to achieve generalization of the results and wider utilization of the designed program.
Studding factors affecting patients’ compliance with therapeutic regimen post knee replacement operation
Follow up care for patients undergoing knee replacement operation through phone calls, home visits and clinical visits would help to pinpoint postoperative patients’ problems and solve it.
Setup a project that aims to improve patient care by implementing evidence based practice.
Health education through mass media concerning joint protection.