The Effect of Discharge Education on Recovery Quality and Self-Efficacy After Hysterectomy

Impact of Orem-Based Discharge Education on Recovery Quality and Self-Efficacy After Hysterectomy: A Randomized Controlled Study

This randomized controlled trial investigated the effect of discharge education based on Orem's Self-Care Theory on postoperative recovery quality and self-efficacy in women undergoing hysterectomy. The study used a pretest/posttest control-group design and included 64 randomly selected women. The study sample consisted of two groups: an intervention group (n=32) and a control group (n=32). Data were collected between December 1, 2024, and May 31, 2025, from women who presented to the Obstetrics and Gynecology clinic of a training and research hospital in Çorum, Türkiye, and met the inclusion criteria. Data were obtained using the Patient Demographic Information Form, the Quality of Recovery-40 Scale, and the General Self-Efficacy Scale. Women in the intervention group received enhanced face-to-face discharge education based on the Orem Self-Care Theory before discharge, while the control group received standard face-to-face discharge education. Pre-test data were collected via self-report in a hospital setting, while post-test data were collected by telephone at the 4th postoperative week from the intervention group, with the researcher marking the questionnaire responses. The data were analyzed using SPSS version 26.0. Descriptive statistics, Pearson chi-square test, independent samples t-tests, paired samples t-tests, and Fisher's exact test were used in the analysis of the data.

Study Overview

• Status: Completed
• Conditions: Hysterectomy (MeSH nr: E04.950.300.399); Had Undergone a Hysterectomy; Had Not Been Diagnosed With Cancer; After Hysterectomy
• Intervention / Treatment: Other: Discharge education based on Orem's self care theory led by a nurse only one time, face-to-face

Detailed Description

In this study, women undergoing hysterectomy surgery will be randomly assigned to two groups. The effects of routine, nurse-led, face-to-face discharge education will be compared with those of face-to-face discharge education based on OREM's self-care theory, focusing on quality of recovery and self-efficacy outcomes.

• Study Type: Interventional
• Enrollment (Actual): 64
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Çorum
    • Çorum, Çorum, Turkey (Türkiye), 19120
      • Hitit University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Women who voluntarily agree to participate in the study
• Women who have undergone hysterectomy
• Conscious and able to respond to questions
• Able to speak and understand Turkish
• No communication problems
• Literate with adequate reading comprehension
• No cognitive impairment
• No diagnosis of cancer

Exclusion Criteria:

• Women with hearing or speech impairments
• Women with cognitive impairment
• Women who underwent emergency hysterectomy
• Patients requiring intensive care in the postoperative period
• Women who do not agree to participate in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Education group; Discharge education based Orem's Self Care Theory	Other: Discharge education based on Orem's self care theory led by a nurse only one time, face-to-face; discharge education led by a nurse based Orem's Self Care Theory; Other Names: discharge education; discharge training
No Intervention: Control Group; Routine Discharge education

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-Efficacy Scale	Developed by Sherer et al. in 1982, the scale is used to assess patients' general self-efficacy. The original version of the scale, for which Turkish validity and reliability studies have been conducted, consisted of 23 items, while it was revised to 17 items by Yıldırım and İlhan (2010). The scale consists of five-point Likert-type questions (1. Never, 5. Very good). It comprises three sub-dimensions: initiation (2, 4, 5, 6, 7, 10, 11, 12, 17), perseverance (3, 13, 14, 15, 16), and persistence (1, 8, 9). The scoring ranges from 1 to 5, and questions 2, 4, 5, 6, 7, 10, 11, 12, 14, 16, and 17 are reverse-scored. The lowest possible score on the scale is 17, and the highest is 85. A high score on the scale indicates a high level of self-efficacy belief. In the validity and reliability study of the scale, the Cronbach's Alpha internal consistency coefficient was determined as 0.80 (Efendioğlu, 2024). In this study, the Cronbach's Alpha internal consistency coefficient was found to be 0.8	4 weeks
The Quality of Recovery-40 Questionnaire	Developed by Myles and colleagues in 2000, this scale assesses the quality of recovery in patients. Its Turkish validity and reliability were established in 2014. The Quality of Recovery-40 Questionnaire consists of 40 items encompassing five sub-dimensions: Emotional State (9 questions), Physical Comfort (12 questions), Patient Support (7 questions), Physical Independence (5 questions), and Pain (7 questions). The Quality of Recovery-40 Questionnaire is divided into Part A and Part B. Part A addresses how the patient felt in the last 24 hours, and responses are requested for each item. Part B inquires about the presence of specific physical or emotional symptoms in the last 24 hours. Questions are evaluated using a 5-point Likert scale. The total score is obtained by summing all items. A score of 40 indicates "very poor quality of recovery," and a score of 200 indicates "excellent quality of recovery." The Cronbach's alpha coefficient of the Quality of Improvement-40 Questionnaire w	4 weeks

Collaborators and Investigators

• Sponsor: Hitit University
• Collaborators: Erol Olcok Corum Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2024
• Primary Completion (Actual): May 31, 2025
• Study Completion (Actual): July 1, 2025

Study Registration Dates

• First Submitted: March 12, 2026
• First Submitted That Met QC Criteria: April 16, 2026
• First Posted (Actual): April 20, 2026

Study Record Updates

• Last Update Posted (Actual): April 24, 2026
• Last Update Submitted That Met QC Criteria: April 21, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Nursing; Quality of Recovery; Hysterectomy; Postoperative recovery; Orem's Self-Care Model; Discharge Education; Self- Efficacy; Gynecological hysterectomy
• Other Study ID Numbers: Ethics number 2024-GOAEK-0424; Master Thesis (Other Identifier: Hitit University); Ethic committee aproval number (Other Identifier: Hitit University)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Age, education level, marital status, income level, family type, partner's age and the other quantitative data
• IPD Sharing Time Frame: 01/ DEC/ 2026 "5 years after study completion
• IPD Sharing Access Criteria: De-identified individual participant data (IPD) and supporting documents (study protocol and informed consent form) will be available to qualified researchers who submit a reasonable request. Access will be provided via secure email or institutional data-sharing platform after approval by the principal investigator. Data will include study variables related to post-hysterectomy recovery, self-care education, and self-efficacy outcomes. Personal identifiers will not be shared to ensure participant confidentiality.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ICF

Drug and device information, study documents

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