The Impact of Web-Based Education on Self-Care Power, Self-Efficacy, and Quality of Life in Knee Arthroplasty Patients.

March 4, 2025 updated by: Serap Sayar, KTO Karatay University

The Effect of Web-Based Education Program Applied to The Patients Undergoing Knee Arthroplasty on Self-Care Power, Self-Efficacy, and Quality of Life

The knee joint, which we use actively every day, is the largest joint in our body that bears the weight, allowing various movements such as walking, running, squatting, and standing. It involves the largest load-bearing structures in the body, including bones, cartilage, surrounding muscles, and ligaments, facilitating the mobilization of the joint. Due to constant use, the knee joint is susceptible to injuries and wear. Total knee arthroplasty (TKA) surgery involves replacing a degenerated joint surface, often due to conditions like osteoarthritis or rheumatoid arthritis, with a metal or polyethylene prosthesis. TKA, a widely used and highly successful surgical intervention in recent years, reduces pain, enhances functional range of motion, and improves independence and quality of life. Severe pain following TKA surgery restricts the movement of the knee joint and daily life activities, leading to the patient's inadequacy in self-care. Patients undergoing TKA surgery often face a lack of information after discharge. This lack of knowledge, coupled with uncertainty about the disease, limits the patient's self-efficacy. As the self-care power diminishes for patients struggling with daily life activities, their self-efficacy is negatively affected. The continuity of education becomes crucial since the verbal and written instructions given after surgery may not be sustained, causing a gradual decline in an individual's self-efficacy. As seen in the literature, studies have shown that postoperative pain, swelling, joint stiffness, fear, and movement limitations negatively impact the quality of life for patients undergoing TKA. Consequently, the self-care capacity, self-efficacy levels, and quality of life for individuals who have undergone TKA are adversely affected, as indicated in the literature.Ensuring continuity of care at home is crucial not only during the early postoperative period in the clinic but also after discharge. The nurse plays a significant role as an educator/advisor after discharge. The nurse provides counseling to patients discharged after Total Knee Arthroplasty (TKA) on pain management, disease progression, rehabilitation process, exercises, and considerations during daily activities (such as walking, bathing, toileting). Additionally, the nurse offers guidance on late-stage complications that may arise at home due to surgery and situations requiring hospitalization. While web-based educational interventions have been conducted for various patient groups, a web-based education program specifically for TKA surgery has not been identified. Having web-based post-TKA patient education allows continuous monitoring, assesses attendance and effectiveness remotely, and enables individuals to convey requests and questions to researchers through live support, ultimately enhancing the effectiveness of education. This approach is believed to prevent complications, reduce patient care costs and readmissions, increase patients' self-sufficiency in self-care, and consequently elevate their self-efficacy levels and quality of life. Close monitoring of postoperative patients is expected to improve their quality of life and self-care abilities, leading to increased satisfaction with healthcare services.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The knee joint, actively used every day, is the largest joint in our body, supporting the body's weight and enabling various movements such as walking, running, squatting, and standing. It involves the most load-bearing structures: bones (distal femur, proximal tibia, and patella), cartilage (meniscus and articular cartilage), surrounding muscles, and ligaments (infrapatellar fat pad), facilitating joint mobilization. Due to constant use, the knee joint is prone to injuries and wear, making it the most common site for Osteoarthritis (OA). In the treatment of knee OA, conservative measures, medical treatments, and physical therapy are utilized in the early stages. However, when these treatments are ineffective, arthroplasty surgery, a commonly used surgical method, is often employed. Total Knee Arthroplasty (TKA) involves replacing a degenerated joint surface (femoral, tibial, and patellar joints) with a metal or polyethylene prosthesis. TKA, a widely used and highly successful surgical intervention in recent years, reduces pain, enhances functional range of motion, and improves independence and quality of life. Although TKA is a successful surgical treatment method, it can also lead to postoperative complications and undesired situations in patients. Post-TKA, patients often require support and information to regain their previous independence, especially since severe postoperative pain restricts knee joint movement and daily life activities, leading to insufficient self-careLiterature indicates that patients undergoing Total Knee Arthroplasty (TKA) experience adverse effects on their self-care power, self-efficacy levels, and quality of life. In this context, nurses, who are primarily responsible for patient care, have significant duties. Besides early postoperative care in the clinic, ensuring the continuity of home care after discharge is crucial. It has been reported in the literature that the care needs of discharged patients continue at home, and patients require high levels of education to safely continue their lives with a joint prosthesis. After discharge, the nurse's role as an educator/advisor becomes crucial. The nurse provides detailed counseling to patients discharged after TKA. The education provided by nurses enables patients to adapt to living with a joint prosthesis and actively participate in decisions related to their own care. With advancements in information technology, patient education has transitioned to the web using devices such as phones, tablets, and computers. Web-based education is advantageous due to constant access to information and the provision of continuous education through written and visual materials.As seen in the literature, web-designed educational studies have been conducted on different patient groups, but no web-designed educational study has been found after TKA surgery. Having a web design for post-TKA patient education will increase the effectiveness of the training, as patients can be tracked at any time, the effectiveness of the training can be measured remotely, whether they attend the training or not, and the researcher can send their requests and questions via live support, thus preventing possible complications, reducing patient care costs and re-use. It is thought that it will reduce hospitalizations, increase the self-care power of patients by becoming self-sufficient, and therefore increase their self-efficacy levels and quality of life. It is predicted that patients' satisfaction with health care services will increase as their quality of life and self-care abilities will increase when they are closely monitored one-on-one after the surgery.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
67

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Turkey
      • Konya, Turkey, 42020
        • Konya City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Being 18 years or older

  • First time performing Total Knee Arthroplasty
  • Ability to access the internet via smart phone, tablet, computer
  • Must have the ability to use smart phones and tablets
  • Ability to read and understand Turkish
  • No mental, psychiatric or neurological disability

Exclusion Criteria:

  • Complications develop in the patient during the research.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental
When patients come to the polyclinic for a check-up 15 days after discharge, the web-designed training program site will be promoted. The patient who accepts the research will be given a user name and password specifically created by the researcher. The patient will be explained practically how to log in to the system at home via phone. Patients will be asked to watch educational videos on the website at least twice a week for one month. Then, pre-test data, Personal Information Form, Self-Efficacy Scale, Self-Care Power Scale and Quality of Life Scale data will be collected. Patients who receive training for a month will be asked to fill out the self-efficacy scale, self-care power scale and quality of life scale for post-test data via the mobile application at the end of the month.
Behavioral: Web-based education
The patient discharged after knee arthroplasty surgery will attend a follow-up appointment 15 days later, and during this visit, they will be granted permission to resume work. The patient will receive detailed information about accessing, entering, and using the web-based training. Scales with pre-test data will be completed by the patient. They will be encouraged to log in at least twice a week, and the patient will be monitored for a total of 1 month (4 weeks). After one month, the patient will be asked to fill out the scales again.
No Intervention: Control Group
When patients come to the outpatient clinic for a check-up 15 days after discharge, they will be asked to fill out the Personal Information Form, Self-Efficacy Scale, Self-Care Ability Scale, and Quality of Life Scale by face-to-face information collection method.Patients will receive routine treatment, care and checks in line with the institutional policy. A web designed training program will not be implemented. One month after the pre-test data is collected, patients will be called and asked to fill out the self-efficacy scale, self-care ability scale and quality of life scale when they come to the outpatient clinic.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Personal Information Form
Time Frame: 1 Minutes
The personal information form has been created by researchers based on a literature review. This form includes a total of 14 questions covering sociodemographic and introductory characteristics of the patient, such as age, gender, weight, height, BMI, marital status, education level, occupation, employment status, cohabitants, presence of chronic diseases, regularly used medications, and the status of receiving discharge education.
1 Minutes

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Self-Care Power Scale
Time Frame: 3 Minutes
The Self-Care Power Scale is designed to measure an individual's ability to take care of themselves or assess their capabilities. The scale consists of 35 items, each rated on a five-point Likert scale ranging from 0 to 4. Scores on the scale range from a minimum of 0 to a maximum of 140, with higher scores indicating an increase in self-care power. The Cronbach's Alpha value for the scale is 0.92.
3 Minutes

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Self-Efficacy - Competence Scale
Time Frame: 2 Minutes
The Self-Efficacy-Competence Scale is a Likert-type self-assessment scale designed to evaluate behavior and behavioral changes. The highest possible score on the scale is 115, and the lowest is 23. A higher total score on the scale indicates a high general perception of self-efficacy and competence, while a lower total score suggests a low perception of self-efficacy and competence. The Cronbach's alpha coefficient for the scale is 0.81.
2 Minutes
Short Form 36 Quality of Life Scale
Time Frame: 4 Minutes
Short Form 36 Quality of Life Scale is designed to assess the quality of life. The reliability coefficient (α-Cronbach) of the scale ranges between 0.73 and 0.76. The scale consists of 8 subscales related to health, totaling 36 items. Separate total scores are provided for each subscale, with scores ranging from 0 to 100. A decrease in scores from the scale indicates poor quality of life, while an increase suggests good quality of life.
4 Minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
KTO Karatay University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Serap SAYAR, PhD, KTO Karatay University
  • Principal Investigator: Esra Nur BOZTAŞ, MScN, Konya City Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 1, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 30, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 10, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 2, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 7, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 12, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 4, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2023/024

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The researcher at Konya City Hospital will collect the data.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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