Effect of preoperative instruction and support interventions on anxiety for arthroplasty patients

Surgery is an anxiety producing time for patients. The extensive physical rehabilitation and decreased initial mobility related to total knee arthroplasties could produce additional concerns and anxiety for patients. It has been documented that preoperative teaching may reduce patients' anxiety. Preoperative teaching enhanced with additional anxiety reduction instruction and support interventions may reduce the patients' preoperative anxiety. The purpose of this study is to determine if enhanced preoperative teaching on anxiety reduction methods with support interventions is an effective method of decreasing total knee arthroplasty patients' preoperative anxiety. This quasi-experimental study examines differences between preoperative education approaches in two groups of total knee arthroplasty patients, one with traditional preoperative education and the other with enhanced preoperative education and support interventions. The conceptual framework for the study is Roy's Adaptation Model (RAM). Participants will be drawn from a population of patients at a Midwestern hospital scheduled for total knee arthroplasty surgery over a six-month period. The anticipated sample will be 50. Surgeons who perform total knee arthroplasties will be informed of the study and approached for consent to include patients in the study. Before the study, informed consent describing the purpose of the study, potential risks and benefits, voluntary participation, right to confidentiality, and right to withdrawal will be given and written consent obtained. The inclusion criteria will be patients that are scheduled for total knee arthroplasties. Patients who have had prior total knee arthroplasty surgery on either knee will be excluded. Also excluded will be patients with psychiatric problems of anxiety. Subjects will be alternately assigned to either the experimental or the control group upon admission to the hospital and will complete the State-Trait Anxiety Inventory (STAI) form (Spielberger, 1983). Both groups will receive the same preoperative education regarding the surgery. The experimental group will receive enhanced instruction on anxiety reduction methods and support interventions. Results will provide information on the effectiveness of enhanced preoperative education.