Pain, Postoperative, Total Joint Arthroplasty
Conditions
Keywords
Pain Education, Information Delivery, Mobile Application
Brief summary
The purpose of this study is to explore the clinical impact of pain management education using a mobile web-based education delivery system compared to standard education delivery. This study seeks to understand the difference between two different education delivery methodologies and the effect on the postoperative pain experience, including participation in treatment plan, knowledge, pain outcomes, and opioid requirements in patients undergoing major hip (THA) and knee (TKA) arthroplasty. It is hypothesized that a real-time, interactive, mobile education system will demonstrate improved pain associated outcomes and higher patient participation when compared to the current standard education delivery method.
Interventions
OTHERMobile Education Delivery
Patients will be provided with an iPad on admission to the post-surgical unit and will remain with the patient until discharge. The patient, independently or with the nurse, may use the program at any point during the inpatient care experience. The RN will use the iPad to engage patients in their pain management.
OTHERStandard Verbal and Written Education
Patients will be provided with two pamphlets on pain management on admission to the post-surgical unit. Nurses will follow-up with verbal instruction based on patient need. This will continue through hospital stay. Additional printed education materials are available through the department of patient education and verbal instruction may be tailored based on nursing assessment and patient need.
Sponsors
George Washington University
Mayo Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
This prospective study has been designed as quasi-experimental study. This study seeks to explore both a treatment and control group in efforts to compare outcomes which are dependent on the type of intervention. Study participants will be assigned into one of two study arms, intervention or control, based on random assignment determined by the location they are bedded in hospital. One of two patient care units will offer standard education, the other unit will offer the mobile, iPad based education. The patient care unit to offer the mobile, iPad based education will be selected at random.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Inclusion: * Adult patients * over the age of 18 years * undergoing surgical intervention and inpatient care for one of the following procedures: * total hip arthroplasty (THA) (primary, bilateral, and revision) * total knee arthroplasty (TKA) (primary, bilateral, unicompartmental, and revision) * Fluent in the English language Exclusion: * Undergoing more complex hip and knee procedures such as: * implant resections with or without spacer placement * liner exchange * THA or unipolar hip arthroplasty related to repair of hip fracture. * Preexisting physical or cognitive limitations that would hinder their ability to use the mobile application
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difference in self-reported pain scores | Post-intervention, at the time of discharge from the hospital (between 1 and 5 days post-surgery) | Scores are measured using a 10 point (Lickert) pain rating scale. The scale ranges from 0 to 10 with the lower score indicating less pain and the higher score indicating greater pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in pain management knowledge | Pre-intervention (between 1 and 5 days before surgical procedure) and post-intervention, at the time of discharge from the hospital (between 1 and 5 days post-surgery) | Scores are measured using a modified Patient Pain Questionnaire; 9 knowledge based questions use a ten-point (0-10) ordinal scale to assess patients' agreement or disagreement with specific statements. All items have been formatted so that zero indicates the most positive outcome and a ten indicates the most negative outcome. |
| Difference in self-reported participation in pain management | Post-intervention, at the time of discharge from the hospital (between 1 and 5 days post-surgery) | Scores are measured using a 10 point Lickert scale measuring patients perception of participation in pain management/treatment decisions. The scale ranges from 0 to 10 with the lower score indicating less perceived participation and the higher score indicating greater perceived participation. |
| Difference in post-operative opioid requirements | Post-intervention, at the time of discharge from the hospital (between 1 and 5 days post-surgery) | Total opioid requirements, converted to morphine milligram equivalents |
| Difference in usefulness of education | Post-intervention, at the time of discharge from the hospital (between 1 and 5 days post-surgery) | Scores are measured using a 10 point Lickert rating scale. The scale ranges from 0 to 10 with the lower score indicating lower perceived usefulness and the higher score indicating greater perceived usefulness. |
| Difference in use of non-pharmacologic pain modalities | Post-intervention, at the time of discharge from the hospital (between 1 and 5 days post-surgery) | Results are tabulated for a descriptive selection list for patients to report what interventions were used. |
Countries
United States
Outcome results
None listed