Effect of Teach-Back-Based Discharge Education in Lower Extremity Surgery Patients

The Effect of Teach-Back-Based Discharge Education on Learning Needs and Readiness for Hospital Discharge in Patients Undergoing Lower Extremity Surgery: An Experimental Study

This study aims to determine the effect of discharge education based on the Teach-Back method on patients' learning needs and readiness for hospital discharge following lower extremity surgery. Lower extremity surgeries are associated with pain, limited mobility, and decreased self-care ability, which may negatively affect recovery and quality of life. Effective discharge education is therefore essential to support postoperative recovery and continuity of care.

This randomized controlled experimental study will be conducted with patients undergoing lower extremity surgery in an orthopedic clinic. Participants will be randomly assigned to an intervention group receiving Teach-Back-based discharge education and a control group receiving routine discharge education. Data will be collected at three time points (before the intervention, at discharge, and 15 days after discharge) using standardized instruments, including the Readiness for Hospital Discharge Scale-Short Form and the Patient Learning Needs Scale.

The findings of this study are expected to contribute to improving discharge education practices, enhancing patient readiness for discharge, and reducing postoperative complications and unmet educational needs.

Study Overview

• Status: Completed
• Conditions: Postoperative Care; Patient Education; Lower Extremity Surgery
• Intervention / Treatment: Behavioral: Teach-Back Education; Behavioral: Routine Discharge Education

Detailed Description

Lower extremity surgeries, including procedures such as fracture repair, arthroplasty, and arthroscopy, are commonly performed interventions that may lead to postoperative pain, limited mobility, and decreased functional capacity. These factors can negatively affect patients' self-care ability, recovery process, and overall quality of life. Effective discharge planning and patient education are therefore essential components of postoperative care, particularly in ensuring continuity of care and preventing complications after discharge.

The Teach-Back method is an evidence-based educational approach that involves asking patients to explain the information provided to them in their own words. This method enhances patient understanding, improves adherence to treatment plans, and reduces the risk of errors and complications. It also allows healthcare professionals to assess comprehension and provide additional clarification when needed.

This study is designed as a randomized controlled experimental study to evaluate the effect of Teach-Back-based discharge education on patients undergoing lower extremity surgery. The study will be conducted in the orthopedic clinic of a state hospital. Participants will be randomly assigned to either the intervention group or the control group using block randomization to ensure balanced group allocation.

Patients in the intervention group will receive structured discharge education based on the Teach-Back method, which includes explanations of postoperative care, medication use, pain management, wound care, mobility and exercise, prevention of complications such as thrombosis and infection, nutrition, and home care needs. Patients will be encouraged to repeat the information in their own words, and any misunderstandings will be corrected through re-education and reassessment. The control group will receive routine discharge education provided in the clinical setting.

Data will be collected at three time points: before the intervention (baseline), at the time of discharge, and 15 days after discharge during outpatient follow-up. Data collection tools include a Patient Information Form, the Readiness for Hospital Discharge Scale-Short Form, the Patient Learning Needs Scale (PLNS), and an Education Evaluation Form.

The primary outcomes of the study are patients' readiness for discharge and learning needs. Secondary outcomes include knowledge retention, complication awareness, and potential hospital readmission or adverse events during the follow-up period.

The findings of this study are expected to contribute to the development of effective, patient-centered discharge education strategies and to improve postoperative outcomes in patients undergoing lower extremity surgery.

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

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • şehitkamil
    • Gaziantep, şehitkamil, Turkey (Türkiye), 27090
      • Gaziantep University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:Aged 18 years or older Undergoing lower extremity surgery in the orthopedic clinic Able to communicate and understand the education provided Willing to participate in the study Able to complete all data collection tools (pre-test and post-test assessments)

Exclusion Criteria:

• Patients who do not fully participate in the education program or data collection process Patients who withdraw from the study at any stage Patients who are readmitted to the hospital due to postoperative complications Patients with incomplete or missing data

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Teach-Back Education Group; Participants will receive discharge education based on the Teach-Back method, including postoperative care, medication use, wound care, mobility, and complication prevention	Behavioral: Teach-Back Education; Structured discharge education based on the Teach-Back method to improve patient understanding and adherence.
Active Comparator: Routine Education Group; Participants will receive routine discharge education provided according to standard clinical practice.	Behavioral: Routine Discharge Education; Standard discharge education provided in routine clinical care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Readiness for Hospital Discharge	Patients' readiness for hospital discharge will be assessed using the Readiness for Hospital Discharge Scale-Short Form. Higher scores indicate greater readiness for discharge	Immediately after training (Post-test) and 4 weeks after training (Follow-up)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Learning Needs	Patients' learning needs will be assessed using the Patient Learning Needs Scale (PLNS). Higher scores indicate greater perceived learning needs.	At hospital discharge (Day of discharge, within 24 hours)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Post-discharge complications	The incidence of post-discharge complications will be assessed based on patient follow-up records.	Within 15 days after discharge

Collaborators and Investigators

• Sponsor: University of Gaziantep

Publications and helpful links

General Publications

• 1. Zhu Y, Yang B, Wang Y. Effects of comfort nursing combined with rehabilitation training on joint function, pain level and quality of life in patients with lower extremity fractures. Archives of Clinical Psychiatry [Internet]. 13 Eylül 2023 [a.yer 05 Haziran 2025];50(6). Erişim adresi: https://archivespsy.com/menu-script/index.php/ACF/article/view/1336 2. Bektaşoğlu B, Eyi̇ S. Alt Ekstremite Cerrahisi Geçiren Bireylerin Kolcaba'nın Konfor Kuramına Göre Bakımı. Hemşirelik Bilimi Dergisi. 25 Aralık 2021;4(3):148-55. 3. Zheng Y, Yan Q. Effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures. BMC Nurs. 20 Ekim 2023;22(1):395. 4. Talevski J, Shee AW, Rasmussen B, Kemp G, Beauchamp A. Teach-back: A systematic review of implementation and impacts. PLOS ONE. 14 Nisan 2020;15(4):e0231350. 5. Değer TB, Gönderen Çakmak HS, Cihan Erdoğan B, Değer MÖ. Effect of Insulin Pen Training Using the Teach-Back Method on Diabetes Self-Management, Quality of Life, and HbA1c Levels in Older Patients with Type 2 Diabetes: A Quasi-Experimental Study. Healthcare. Ocak 2024;12(18):1854. 6. Yen PH, Leasure AR. Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Fed Pract. Haziran 2019;36(6):284-9. 7. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in psychology. 2013;4:863. 8. [a.yer 23 Haziran 2025]. Erişim adresi: Abrams MA, Nielsen GA, Wilson A. Always Use Teach-back! Toolkit. 2024. https://teachbacktraining.org. 9. Use the Teach-Back Method: Tool #5 [Internet]. [a.yer 23 Haziran 2025]. Erişim adresi: https://www.ahrq.gov/health-literacy/improve/precautions/tool5.html 10. Sayar S. Ortopedi hastalarında taburculuk eğitimi ve yenilikçi uygulamalar. 2025 [a.yer 23 Haziran 2025]; Erişim adresi: https://acikerisim.karatay.edu.tr/yayinaea/pdf1449_67caf4d44955b.pd

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2025
• Primary Completion (Actual): March 30, 2026
• Study Completion (Actual): March 30, 2026

Study Registration Dates

• First Submitted: April 15, 2026
• First Submitted That Met QC Criteria: April 22, 2026
• First Posted (Actual): April 30, 2026

Study Record Updates

• Last Update Posted (Actual): April 30, 2026
• Last Update Submitted That Met QC Criteria: April 22, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Patient Education; Postoperative Care; Teach-Back Method; Discharge Education; Lower Extremity Surgery
• Other Study ID Numbers: 2025/102 (Registry Identifier: Hasan Kalyoncu University Non-Interventional Ethics Committee)

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