Amprachim Sara Eleni, Vlamis John, Vlami Melina J, Nikolaou Vasileios S, Pneumaticos Spyros G
3rd Department of Orthopaedics, National and Kapodistrian University of Athens School of Medicine, KAT Attica General Hospital, Athens, GRC.
2nd Department of Orthopaedics, National and Kapodistrian University of Athens School of Medicine, Athens, GRC.
Cureus. 2024 Nov 17;16(11):e73841. doi: 10.7759/cureus.73841. eCollection 2024 Nov.
Introduction Preoperative patient information and education is an essential aspect of modern surgical care, particularly for patients undergoing total hip arthroplasty (THA). This prospective, randomized trial aimed to assess the effects of structured preoperative education and information on clinical outcomes in patients undergoing THA. Materials and methods A total of 102 patients were randomized into two groups: the intervention group (n = 51) receiving standardized preoperative information and education, and the control group (n = 51) receiving standard preoperative care without a formal educational component. Postoperative outcomes, including functionality, mobility, length of hospital stay (LOS), patient satisfaction, health-related quality of life, anxiety, depression and fear for surgery, were compared between the two groups. Results Both groups were comparable in baseline characteristics, including age, sex, body mass index (BMI), smoking status and alcohol consumption. The mean age was 66.3 years, mean BMI was 29.05 and 70.6% of participants were female. Patients in the intervention group had a shorter mean hospital stay (mean 4.9 days vs. 6.2 days, p=0.031). Mean preoperative modified Harris Hip Score (mHHS) was similar between the two groups (p = 0.866). However, one month postoperatively, mHHS was significantly higher in the intervention group compared to controls (74.06 versus 67.81, p = 0.046). The absolute change in European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L) Index and EQ-5D-5L Visual Analogue Scale (VAS) score before and after THA was statistically significant (p = 0.021 and p = 0.042). Preoperative and postoperative depression was significantly lower in the intervention group, one day preoperatively, one day before discharge and one month postoperatively, as shown by the Hospital Anxiety and Depression Scale (HADS) (p = 0.026, p = 0.027 and p = 0.018 respectively). Conclusions This prospective, randomized trial demonstrated that preoperative education and information significantly improve clinical outcomes, duration of hospitalization, health-related quality of life and postoperative anxiety in patients undergoing THA. These findings underline the importance of incorporating structured educational programs into preoperative care protocols prior to THA for enhancing patient recovery and optimizing postoperative results.
引言 术前患者信息与教育是现代外科护理的重要方面，对于接受全髋关节置换术（THA）的患者尤为如此。这项前瞻性随机试验旨在评估结构化术前教育和信息对接受THA患者临床结局的影响。
材料与方法 总共102例患者被随机分为两组：干预组（n = 51）接受标准化术前信息与教育，对照组（n = 51）接受无正式教育内容的标准术前护理。比较两组术后结局，包括功能、活动能力、住院时间（LOS）、患者满意度、健康相关生活质量、焦虑、抑郁以及对手术的恐惧。
结果 两组在基线特征方面具有可比性，包括年龄、性别、体重指数（BMI）、吸烟状况和饮酒量。平均年龄为66.3岁，平均BMI为29.05，70.6%的参与者为女性。干预组患者的平均住院时间较短（平均4.9天对6.2天，p = 0.031）。两组术前改良Harris髋关节评分（mHHS）相似（p = 0.866）。然而，术后1个月，干预组的mHHS显著高于对照组（74.06对67.81，p = 0.046）。THA前后欧洲生活质量五维度五级（EQ-5D-5L）指数和EQ-5D-5L视觉模拟量表（VAS）评分的绝对变化具有统计学意义（p = 0.021和p = 0.042）。根据医院焦虑抑郁量表（HADS）显示，干预组术前一天、出院前一天和术后1个月的术前及术后抑郁水平显著较低（分别为p = 0.026、p = 0.027和p = 0.018）。
结论 这项前瞻性随机试验表明，术前教育和信息显著改善了接受THA患者的临床结局、住院时间、健康相关生活质量和术后焦虑。这些发现强调了在THA术前护理方案中纳入结构化教育项目对于促进患者康复和优化术后结果的重要性。
