Volume 11, Issue 1 (2023)                   Health Educ Health Promot 2023, 11(1): 45-51 | Back to browse issues page

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Akbari A, Rajabzadeh R, Hosseini S, Jafari Y, Mohaddes Hakkak H, Ganji R. Effect of Educational Intervention on Reducing Anxiety in Patients with Knee Arthroplasty: A Quasi-Experimental Study. Health Educ Health Promot 2023; 11 (1) :45-51
URL: http://hehp.modares.ac.ir/article-5-64574-en.html
1- “Student Research Committee” and “Department of Medicine, School of Medicine”, North Khorasan University of Medical Sciences, Bojnurd, Iran
2- Department of Epidemiology, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
3- Department of Health Education and Health Promotion, School of Health Public, North Khorasan University of Medical Sciences, Bojnurd, Iran
4- Department of Orthopedic Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
Abstract:   (588 Views)
Aims: Any surgery could be an anxiety-provoking event. A high level of preoperative anxiety may change the result of surgery. This study aimed to determine the effects of training intervention on anxiety in patients undergoing knee replacement.
Materials & Methods: This quasi-experimental study was conducted on 90 patients who were candidates for knee joint replacement surgery in teaching hospitals of Bojnord city in North khorasan Province in 2021. Patients were enrolled in three 90-minute sessions. In the first two sessions, the surgeon informed the patients about the disease, treatment approaches, surgery, and anesthesia, and in the last session, the clinical psychologist instructed them on how to control and deal with anxiety. Anxiety was assessed before, immediately after the intervention, and one day before surgery.
Findings: The mean scores of state anxiety before, immediately after the intervention, and one day before surgery were 44.38±10.76, 41.49±9.41, and 36.19±6.40, respectively. Moreover, the mean scores of trait anxiety before, immediately after the intervention, and one day before surgery were 43.87±10.81, 41.27±8.39, and 38.83±6.56, respectively, which show the effectiveness of the intervention in controlling patients' anxiety (p<0.05).
Conclusion: Informing the patients about their disease and how to deal with it and giving awareness about the effectiveness of the operation by the surgeon and the clinical psychologist is effective in controlling and reducing anxiety.

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Article Type: Original Research | Subject: Technology of Health Education
Received: 2022/10/3 | Accepted: 2023/01/1 | Published: 2023/02/14
* Corresponding Author Address: Department of Orthopedic Surgery, School of Medicine, North Khorasan University of Medical Sciences, Shahada Arkan Boulevard (Arkan Road), Bojnurd, Iran. Postal Code: 9453155166 (r.ganji@nkums.ac.ir)

1. Price A, Jackson W, Alvand A. Outcome measurement and auditable standards of care in revision knee surgery. Knee. 2020;27(5):1693-5. [Link] [DOI:10.1016/j.knee.2020.07.081]
2. Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Orthop Traumatol Surg Res. 2018;104(1):S41-6. [Link] [DOI:10.1016/j.otsr.2017.04.017]
3. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014;30(1):149-60. [Link] [DOI:10.1185/03007995.2013.860019]
4. Uddin I, Kurkuman A, Jamil T, Iftikhar R. Pre-operative anxiety in patients admitted for elective surgery in King Saud Hospital, Unaizah, Al-Qassim, Kingdom of Saudi Arabia. Pakistan J Med Sci. 2002;18(4):306-10. [Link]
5. Akinsulore A, Owojuyigbe AM, Faponle AF, Fatoye FO. Assessment of preoperative and postoperative anxiety among elective major surgery patients in a tertiary hospital in Nigeria. Middle East J Anaesthesiol. 2015;23(2):235-40. [Link]
6. Padmanabhan R, Hildreth A, Laws D. A prospective, randomised, controlled study examining binaural beat audio and pre‐operative anxiety in patients undergoing general anaesthesia for day case surgery. Anaesthesia. 2005;60(9):874-7. [Link] [DOI:10.1111/j.1365-2044.2005.04287.x]
7. Bedaso A, Ayalew M. Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia. Patient Saf Surg. 2019;13(1):18. [Link] [DOI:10.1186/s13037-019-0198-0]
8. Roomruangwong C, Tangwongchai S, Chokchainon AA. Preoperative anxiety among patients who were about to receive uterine dilatation and curettage. J Med Assoc Thai. 2012;95(10):1344. [Link]
9. Gataa R, Ajmi TN, Bougmiza I, Mtiraoui A. Morbidity patterns in general practice settings of the province of Sousse, Tunisia. Pan Afr Med J. 2009;3:11. [Link] [DOI:10.4314/pamj.v3i1.52450]
10. Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596-606. [Link] [DOI:10.1136/bjsm.2010.076364]
11. Pérez-Prieto D, Gil-González S, Pelfort X, Leal-Blanquet J, Puig-Verdié L, Hinarejos P. Influence of depression on total knee arthroplasty outcomes. J Arthroplasty. 2014;29(1):44-7. [Link] [DOI:10.1016/j.arth.2013.04.030]
12. Chen S-B, Hu H, Gao Y-S, He H-Y, Jin D-X, Zhang C-Q. Prevalence of clinical anxiety, clinical depression and associated risk factors in chinese young and middle-aged patients with osteonecrosis of the femoral head. PloS One. 2015;10(3):e0120234. [Link] [DOI:10.1371/journal.pone.0120234]
13. Erkilic E, Kesimci E, Soykut C, Doger C, Gumus T, Kanbak O. Factors associated with preoperative anxiety levels of Turkish surgical patients: from a single center in Ankara. Patient Prefer Adherence. 2017;11:291-6. [Link] [DOI:10.2147/PPA.S127342]
14. Zalikha AK, Karabon P, Hussein IH, El-Othmani MM. Anxiety and depression impact on inhospital complications and outcomes after total knee and hip arthroplasty: a propensity score-weighted retrospective analysis. J Am Acad Orthop Surg. 2021;29(20):873-84. [Link] [DOI:10.5435/JAAOS-D-20-00721]
15. Ghanei RG, Rezaei K, Mahmoodi R. The relationship between preoperative anxiety and postoperative pain after cesarean section. Iran J Obstet Gynecol Infertil. 2013;15(39):16-22. [Persian] [Link]
16. Zakerimoghadam M, Aliasgharpoor M, Mehran A, Mohammadi S. Effect of Patient education about pain control on patients' anxiety prior to abdominal surgery. Hayat. 2009;15(4):13-22. [Persian] [Link]
17. Rezaei K, Ghaneii R. Effect of yoga program on anxiety in Breast cancer patient undergoing chemotherapy. Jentashapir. 2013;4(1):41-51. [Persian] [Link]
18. den Hertog A, Gliesche K, Timm J, Mühlbauer B, Zebrowski S. Pathway-controlled fast-track rehabilitation after total knee arthroplasty: a randomized prospective clinical study evaluating the recovery pattern, drug consumption, and length of stay. Arch Orthop Trauma Surg. 2012;132(8):1153-63. [Link] [DOI:10.1007/s00402-012-1528-1]
19. Jones S, Alnaib M, Kokkinakis M, Wilkinson M, St Clair Gibson A, Kader D. Pre-operative patient education reduces length of stay after knee joint arthroplasty. Ann R Coll Surg Engl. 2011;93(1):71-5. [Link] [DOI:10.1308/003588410X12771863936765]
20. Moulton LS, Evans PA, Starks I, Smith T. Pre-operative education prior to elective hip arthroplasty surgery improves postoperative outcome. Int Orthop. 2015;39(8):1483-6. [Link] [DOI:10.1007/s00264-015-2754-2]
21. Johansson K, Salanterä S, Katajisto J. Empowering orthopaedic patients through preadmission education: results from a clinical study. Patient Educ Couns. 2007;66(1):84-91. [Link] [DOI:10.1016/j.pec.2006.10.011]
22. Egekeze N, Dubin J, Williams K, Bernhardt M. The age of OrthoInfo: a randomized controlled trial evaluating patient comprehension of informed consent. J Bone Joint Surg Am. 2016;98(19):e81. [Link] [DOI:10.2106/JBJS.15.01291]
23. Mohamed K, Foy D, Cogley D, Niall D, Sheehan E. Multidisciplinary approach to consent in arthroplasty surgery. Ir Med J. 2014;107(6):165-6. [Link]
24. Sadeghi S. Standardization Spielberger test [Dissertation]. Tehran: Islamic Azad University; 2002. [Persian] [Link]
25. Gholami Booreng F, Mahram B, Kareshki H. Construction and validation of a scale of research anxiety for students. Iran J Psychiatr Clin Psychol. 2017;23(1):78-93. [Persian] [Link] [DOI:10.18869/nirp.ijpcp.23.1.78]
26. Mirbagher Ajorpaz N, Ezadi A, Heidari S. Comparison of routine education and video CD on anxiety level before general surgery. Qom Univ Med Sci J. 2014;8(5):19-25. [Persian] [Link]
27. Nikandish R, Anvar M, Avand A, Habibi N, Gahramani N, Dorri R. Translation and validation of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) for Iranian population. Res Med. 2007;31(1):79-84. [Persian] [Link]
28. Pritchard MJ. Identifying and assessing anxiety in pre-operative patients. Nurs Stand. 2009;23(51):35-40. [Link] [DOI:10.7748/ns.23.51.35.s46]
29. Ellis HB, Howard KJ, Khaleel MA, Bucholz R. Effect of psychopathology on patient-perceived outcomes of total knee arthroplasty within an indigent population. J Bone Joint Surg Am. 2012;94(12):e84. [Link] [DOI:10.2106/JBJS.K.00888]
30. Kagan I, Bar‐Tal Y. The effect of preoperative uncertainty and anxiety on short‐term recovery after elective arthroplasty. J Clin Nurs. 2008;17(5):576-83. [Link] [DOI:10.1111/j.1365-2702.2007.01968.x]
31. Fehring TK, Odum SM, Curtin BM, Mason JB, Fehring KA, Springer BD. Should depression Be treated before lower extremity arthroplasty? J Arthroplasty. 2018;33(10):3143-6. [Link] [DOI:10.1016/j.arth.2018.05.037]
32. Sjöling M, Nordahl G, Olofsson N, Asplund K. The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management. Patient Educ Couns. 2003;51(2):169-76. [Link] [DOI:10.1016/S0738-3991(02)00191-X]
33. Singh JA, Lewallen DG. Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry. Arthritis Res Ther. 2012;14(6): R248. [Link] [DOI:10.1186/ar4091]
34. Beydon L, Rouxel A, Camut N, Schinkel N, Malinovsky J-M, Aveline C, et al. Sedative premedication before surgery-A multicentre randomized study versus placebo. Anaesth Critic Care Pain Med. 2015;34(3):165-71. [Link] [DOI:10.1016/j.accpm.2015.01.005]
35. Guo P, East L, Arthur A. A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: a randomized controlled trial. Int J Nurs Stud. 2012;49(2):129-37. [Link] [DOI:10.1016/j.ijnurstu.2011.08.008]
36. Jawaid M, Mushtaq A, Mukhtar S, Khan Z. Preoperative anxiety before elective surgery. Neurosci J. 2007;12(2):145-8. [Link]
37. Wennström B, Törnhage CJ, Nasic S, Hedelin H, Bergh I. The perioperative dialogue reduces postoperative stress in children undergoing day surgery as confirmed by salivary cortisol. Pediatr Anesth. 2011;21(10):1058-65. [Link] [DOI:10.1111/j.1460-9592.2011.03656.x]
38. Moemeni L, Yarandi AN, Haghani H. Comparative study of the effects of education using vcd and booklet in two different times on pre-operative anxiety. Iran J Nurs. 2009;21(56):81-93. [Link]
39. Atabaki S, Haghani S, Dorri S, Farahani MA. The effect of rehabilitation education on anxiety in knee replacement patients. J Educ Health Promot. 2020;9:115. [Link] [DOI:10.4103/jehp.jehp_6_20]
40. Edwards PK, Mears SC, Barnes CL. Preoperative education for hip and knee replacement: never stop learning. Curr Rev Musculoskelet Med. 2017;10(3):356-64. [Link] [DOI:10.1007/s12178-017-9417-4]
41. Soffin E, YaDeau J. Enhanced recovery after surgery for primary hip and knee arthroplasty: a review of the evidence. Br J Anaesth. 2016;117(suppl 3):iii62-iii72. [Link] [DOI:10.1093/bja/aew362]
42. Sjöstedt L, Hellström R, Stomberg MW. Patients' need for information prior to colonic surgery. Gastroenterol Nurs. 2011;34(5):390-7. [Link] [DOI:10.1097/SGA.0b013e31822c69b4]
43. Bonnin MP, Basiglini L, Archbold HP. What are the factors of residual pain after uncomplicated TKA? Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1411-7. [Link] [DOI:10.1007/s00167-011-1549-2]
44. Bian T, Shao H, Zhou Y, Huang Y, Song Y. Does psychological distress influence postoperative satisfaction and outcomes in patients undergoing total knee arthroplasty? A prospective cohort study. BMC Musculoskelet Disord. 2021;22(1):647. [Link] [DOI:10.1186/s12891-021-04528-7]
45. Clement N, MacDonald D, Burnett R. Primary total knee replacement in patients with mental disability improves their mental health and knee function: a prospective study. Bone Joint J. 2013;95-B(3):360-6. [Link] [DOI:10.1302/0301-620X.95B3.29563]
46. Tarazona B, Tarazona-Álvarez P, Peñarrocha-Oltra D, Rojo-Moreno J, Peñarrocha-Diago MA. Anxiety before extraction of impacted lower third molars. Med Oral Patol Oral Y Cir Bucal. 2015;20(2):e246-50. [Link] [DOI:10.4317/medoral.20105]

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