Kinesiophobia in Patients Undergoing Total Knee Replacement Surgery

The Effect of Preoperative Education on Kinesiophobia in Patients Undergoing Total Knee Replacement Surgery: A Randomized Controlled Study

Providing information to the patient before surgery has important effects on the patient's self-care skills regarding the treatment and care process, reducing stress and reducing fears in the postoperative period. The primary aim of this study was to examine the effect of preoperative education on kinesiophobia in patients undergoing total knee replacement surgery. In addition, preoperative anxiety levels, time of first postoperative mobilization, number of steps in the first 24 hours after mobilization and pain levels of the patients will be evaluated as secondary outcomes.

Study Overview

• Status: Not yet recruiting
• Conditions: Kinesiophobia
• Intervention / Treatment: Other: Education

Detailed Description

Kinesiophobia is known as the minimization of activities or avoidance of movement due to the fear that the pain caused by movement will negatively affect the person's life and the problem will occur again. It was first defined by Miller, Kopri and Todd in 1990 at the American Pain Society meeting as excessive and unreasonable anxiety against physical movement and pain in the person, which occurs due to the person feeling vulnerable as a result of a painful injury or re-injury. Kinesiophobia is one of the factors that contribute to the chronicization of pain in individuals after surgery; it can lead to negative patient behaviors on the disease in the surgical process. In addition, kinesiophobia can lead to movement limitation and movement limitation can lead to pain. Since this vicious cycle may result in more pain and disability, the importance of the issue is increasing. It has also been shown that patients with high levels of kinesiophobia experience more pain and have a lower quality of life. This research project aims to provide an original approach in a field where studies on preventing or minimizing the effects of kinesiophobia on the surgical process and postoperative recovery process are limited. It is expected that nurses' interventions for kinesiophobia during the operation process will have positive effects on treatment and care. In this study, visual material-supported patient education will be provided to reduce the level of kinesiophobia associated with total knee replacement surgery.

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Bahar Candas Altinbas, PhD; Phone Number: +90 545 9125343; Email: baharcandas88@gmail.com
• Study Contact Backup: Name: Nurdan Reis; Phone Number: +90 546 7832632; Email: nurdangungoreis@gmail.com

Study Locations

• Turkey
  • Trabzon, Turkey, 61800
    • Bahar Candas Altinbas
    • Contact: Bahar Candas Altinbas, PhD; Phone Number: +90 545 9125343; Email: baharcandas88@gmail.com
  • Trabzon, Turkey, 61800
    • Nurdan Reis
    • Contact: Nurdan Reis; Phone Number: +90 6547832632; Email: nurdangungoreis@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• 65 years of age or older
• Planned surgery
• Speaking and understanding Turkish
• Being admitted to the hospital at least one day before the surgery

Exclusion Criteria:

• Visual, hearing and speech disabilities,
• Being mentally disabled,
• Having a psychiatric disorder or being in the process of treatment
• Having had knee replacement surgery before

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control Group; The control group will take rutin patient care.
Experimental: Experimental Group; The experimental group patients will be educated by the nurse in the preoperative period with the support of visual education material	Other: Education; Nurse-led patient education

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Kinesiophobia	Self reported kinesiophobia intensity after surgical process that includes one day after surgery. TAMPA Kinesiophobia Scale (TSK) will be used to evaluate the kinesiophobia. The TSK consists of 17 items that are rated on a 4-point Likert scale, ranging from "Strongly Disagree" to "Strongly Agree." It is scored by assigning a numerical value to each response. Individual item scores range from 1-4, with the negatively worded items (4,8,12,16) having a reverse scoring (4-1). The 17 item TSK total scores range from 17 to 68 where the lowest 17 means no or negligible kinesiophobia, and the higher scores indicate an increasing degree of kinesiophobia.	2 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anxiety level	Self reported anxiety intensity before surgical process that includes on the day of surgery. State-Trait Anxiety Inventory will be used to evaluate the anxiety. The higher the score is the more anxiety.	2 days
Pain level	It means that what is the severity of the pain that the patients had in 24 hours after surgery. It evaluated with Visual Analog Scale. The most common style used in pain measurement uses a horizontal line measuring exactly 10 cm. The patient is asked to make a mark on this line (from 0 to 10), then the line is measured and recorded in millimeters or centimeters. The higher the score is the more severe the pain. The minimum, maximum, median, 25th and 75th quartile were evaluated for each group and compared between the groups.	1 day
First postoperative mobilization time	How many hours after surgery did the patients walk for the first time? This metric will be recorded as day using a questionnaire. The minimum, maximum, median, 25th, and 75th quartiles were calculated for each group and compared. The minimum, maximum, median, 25th and 75th quartile were evaluated for each group and compared between the groups.	1 day
Number of steps in the first 24 hours after mobilization	How many steps did the patients take in 24 hours after surgery? This parameter will be evaluated with a pedometer bracelet to be worn on the arm of the patients. The minimum, maximum, median, 25th and 75th quartile were evaluated for each group and compared between the groups.	1 day

Collaborators and Investigators

• Sponsor: Karadeniz Technical University
• Investigators: Principal Investigator: Bahar Candas Altinbas, PhD, Karadeniz Technical University

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2023
• Primary Completion (Estimated): December 29, 2023
• Study Completion (Estimated): May 29, 2024

Study Registration Dates

• First Submitted: July 10, 2023
• First Submitted That Met QC Criteria: July 10, 2023
• First Posted (Actual): July 18, 2023

Study Record Updates

• Last Update Posted (Actual): July 19, 2023
• Last Update Submitted That Met QC Criteria: July 17, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Preoperative care; Knee replacement; Kinesiophobia; Nursing education
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders; Phobic Disorders; Kinesiophobia
• Other Study ID Numbers: Nurse_Kinesiophobia02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No