Effectiveness of the Transitional Care Model in Total Knee Arthroplasty Patients

Study Overview
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Brief Summary
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The aim of this study was to determine the effectiveness of transitional care in patients with total knee arthroplasty on patients' functional status, perceived self-efficacy, and health care use. Based on the sampling inclusion criteria, we assigned the patients who would undergo knee arthroplasty to the control (n=35) and intervention (n=35) groups, via the block randomization method. The intervention group received transitional care, while the control group received usual care. Data were collected on post-intervention functional status, level of self-efficacy, and hospital visits outside of routine control.

Detailed Description
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This randomised control study was conducted 70 eligible partients with total knee arthroplasty in a public hospital orthopedic and traumatology service. Participants were randomly assigned to receive either the 6-week 'Transitional Care Model' program or usual care. Assessments of self-efficacy and functional status of patients were conducted at baseline, 2nd and 9th weeks after discharge. Time-dependent changes in patient outcomes were assessed by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Self-efficacy Scale (ASES) measurements tools. Assessments of hospital visits outside of routine control were conducted 2nd week, 6th week, 9th week, and 12th weeks after discharge. The functional status of the intervention group patients improved more than the control group according to WOMAC mean scores. Intervention group patients receiving transitional care had higher mean scores at the 2nd-week and 9th-week postoperatively in perceived self-efficacy . Besides, the rate of admission to the hospital in the intervention group was lower compared to the control group, and a significant difference was observed in the 6th-week follow-up.

Official Title
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Effectiveness of the Transitional Care Model in Total Knee Arthroplasty Patients: A Randomized Controlled Study

Conditions
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Pain, Knee Osteoarthritis, Self Efficacy, Health Care Utilization

Intervention / Treatment
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* Other: Transitional care model


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having decided to undergo total knee arthroplasty for the first time due to osteoarthritis Volunteering to participate in the research, not having a psychological, physical, and mental disability that may prevent communication, not having any major chronic problems such as end-stage organ failure, kidney, neurological, cancer Being discharged to the home from a hospital Being able to speak Turkish Being available by phone Being aged 50 and over Exclusion Criteria: Unwillingness to continue the study Rehospitalization Exposure to a disease or trauma that would affect functional independence during the study

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Transitional care<br>This group is the actual intervention group. | Other: Transitional care model<br>* The patients who were assigned to this group with the transitional care model, 6 weeks of counseling and intervention training provided continuity of care and a safe transition, and patients were encouraged about symptom management and a healthy lifestyle.<br>|
| No Intervention: Usual care<br>This group is the routine treatment (control) valid in the clinical practice. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Western Ontario and McMaster Universities Osteoarthritis Index-WOMAC | Assessments of functional status of patients were conducted at baseline, 2nd and 9th weeks after discharge. | up to 9 weeks | 
| Arthritis Self-efficacy Scale (ASES) | Assessments of self-efficacy of patients were conducted at baseline, 2nd and 9th weeks after discharge. | up to 9 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of hospital visits | Assessments of the number of hospital visits outside of routine control were conducted 2nd week, 6th week, 9th week, and 12th weeks after discharge. | up to 12 weeks |