Effectiveness of nursing care models for total knee arthroplasty patients on self-health care behavior, clinical complications, and readmission at the special ward, Kampangsaen Hospital

Abstract

This quasi-experimental, two-group, pre-post test study examined the effectiveness of a nursing model for patients undergoing total knee arthroplasty (TKA) regarding self-care behaviors, clinical complications, and hospital readmission. The sample consisted of 42 TKA patients, divided into an experimental group and a control group (n = 21 each). Research instruments included the nursing model, a self-care behavior interview form, and a clinical complication record form. Content validity was verified by three experts, yielding content validity indices (CVI) of 1.00, 1.00, and 1.00, respectively, while Cronbach’s alpha coefficient for reliability was .82. Data were analyzed using descriptive statistics, Fisher’s exact test, the Friedman test, the Mann–Whitney U test, and Spearman’s rank correlation coefficient.

The results indicated the experimental group demonstrated higher self-care behavior scores than the control group at all time points (p ≤ .010) and lower pain scores immediately post-surgery, as well as at 6, 48, and 72 hours post-operation (p ≤ .020). We observed no significant differences in knee flexion range of motion or the  6-minute walk test (p > .050) but found a significant gender difference between the experimental and control groups (p = .021). In the experimental group, pre-operative and post-operative self-care behaviors were correlated (r_s = .614, p = .003). No evidence of infection, pressure ulcers, falls, or hospital readmission occurred in either the experimental or control group. In conclusion, the nursing model more effectively reduces post-operative pain and enhances self-care behaviors among patients undergoing TKA compared with standard care.