Nurse-led preoperative education on kinesiophobia in older adult patients undergoing total knee arthroplasty: A randomized controlled trial.

AIM: The aim of the study was to evaluate effectiveness of nurse-led preoperative education in reducing kinesiophobia and improving mobilization indicators among older adult patients undergoing total knee arthroplasty.

METHODS

This randomized controlled study was conducted with a total of 120 participants. Patients were randomly assigned to either the control group, which received standard hospital-based health education, or the experimental group, which received nurse-led preoperative education. Baseline data were collected at the first clinical encounter. Following the intervention, kinesiophobia levels and secondary outcomes measures were assessed at four subsequent time points: (1) on the morning of surgery, (2) 24 h after surgery, (3) 24 h after mobilization, and (4) at the time of discharge. Data collection was performed using structured questionnaires, validated scales, and smart bracelet. All statistical analyses were conducted using R software.

RESULTS

The experimental group showed significantly lower kinesiophobia 24 h after mobilization than the control group (3.8 ± 0.2 vs. 4.0 ± 0.3, p < 0.001). Anxiety scores on the morning of surgery were also lower in the experimental group than in the control group (44.0 ± 4.9 vs. 50.4 ± 6.6, p < 0.001). Following surgery, patients in experimental group initiated mobilization earlier and recorded a higher number of steps compared to the control group (p = 0.001). No significant differences were observed between the groups in postoperative pain intensity and length of hospital stay.

CONCLUSION

Nurse-led preoperative education was found to be effective in reducing kinesiophobia and preoperative anxiety while promoting earlier mobilization and greater physical activity among older adult patients undergoing total knee arthroplasty.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov; NCT05950217.