Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Study protocol

Patient participation in postoperative care activities in patients undergoing total knee replacement surgery: Multimedia Intervention for Managing patient Experience (MIME). Study protocol for a cluster randomised crossover trial

Authors: Jo McDonall, Richard de Steiger, John Reynolds, Bernice Redley, Patricia Livingston, Mari Botti

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Patient participation is an important indicator of quality care. Currently, there is little evidence to support the belief that participation in care is possible for patients during the acute postoperative period. Previous work indicates that there is very little opportunity for patients to participate in care in the acute context. Patients require both capability, in terms of having the required knowledge and understanding of how they can be involved in their care, and the opportunity, facilitated by clinicians, to engage in their acute postoperative care. This cluster randomised crossover trial aims to test whether a multimedia intervention improves patient participation in the acute postoperative context, as determined by pain intensity and recovery outcomes.

Methods/design

A total of 240 patients admitted for primary total knee replacement surgery will be invited to participate in a cluster randomised, crossover trial and concurrent process evaluation in at least two wards at a major non-profit private hospital in Melbourne, Australia. Patients admitted to the intervention ward will receive the multimedia intervention daily from Day 1 to Day 5 (or day of discharge, if prior). The intervention will be delivered by nurses via an iPad™, comprising information on the goals of care for each day following surgery. Patients admitted to the control ward will receive usual care as determined by care pathways currently in use across the organization. The primary endpoint is the “worst pain experienced in the past 24 h” on Day 3 following TKR surgery. Pain intensity will be measured using the numerical rating scale. Secondary outcomes are interference of pain on activities of daily living, length of stay in hospital, function and pain following TKR surgery, overall satisfaction with hospitalisation, postoperative complications and hospital readmission.

Discussion

The results of this study will contribute to our understanding of the effectiveness of interventions that provide knowledge and opportunity for patient participation during postoperative in-hospital care in actually increasing participation, and the impact of participation on patient outcomes. The results of this study will also provide data about the barriers and enablers to participation in the acute care context.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12614000340​639 Trial Registration date 31/03/2014.
Literature
1.
Longtin Y, Sax H, Leape LL, Sheridan SE, Donaldson L, Pittet D. Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc. 2010;85(1):53–62.CrossRefPubMedPubMedCentral
2.
3.
4.
Katz MG, Jacobson TA, Veledar E, Kripalani S. Patient literacy and question-asking behavior during the medical encounter: a mixed-methods analysis. J Gen Intern Med. 2007;22(6):782–6.CrossRefPubMedPubMedCentral
5.
Guevara JP, Wolf FM, Grum CM, Clark NM. Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ. 2003;326(7402):1308–9.CrossRefPubMedPubMedCentral
6.
Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the patient activation measure. Health Serv Res. 2005;40(6 Pt 1):1918–30.CrossRefPubMedPubMedCentral
7.
Henderson S. Power imbalance between nurses and patients: a potential inhibitor of partnership in care. J Clin Nurs. 2003;12(4):501–8.CrossRefPubMed
8.
Eldh AC, Ekman I, Ehnfors M. Conditions for patient participation and non-participation in health care. Nurs Ethics. 2006;13(5):503–14.CrossRefPubMed
9.
Hill S. The knowledgeable patient : communication and participation in health. Chichester: Wiley; 2011.CrossRef
10.
Mansell D, Poses RM, Kazis L, Duefield CA. Clinical factors that influence patients’ desire for participation in decisions about illness. Arch Intern Med. 2000;160(19):2991–6.CrossRefPubMed
11.
Arora NK, McHorney CA. Patient preferences for medical decision making: who really wants to participate? Med Care. 2000;38(3):335–41.CrossRefPubMed
12.
13.
Anderson RM, Funnell MM. Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm. Patient Educ Couns. 2005;57(2):153–7.CrossRefPubMed
14.
Den Brink-Muinen V, Van Dulmen SM, De Haes HC, Visser AP, Schellevis FG, Bensing JM. Has patients’ involvement in the decision-making process changed over time? Health Expect. 2006;9(4):333–42.CrossRefPubMed
15.
16.
17.
McGrath B, Elgendy H, Chung F, Kamming D, Curti B, King S. Thirty percent of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5,703 patients. Can J Anesth. 2004;51(9):886–91.CrossRefPubMed
18.
Noyes FR, Mangine RE, Barber S. Early knee motion after open and arthroscopic anterior cruciate ligament reconstruction. Am J Sports Med. 1987;15(2):149–60.CrossRefPubMed
19.
Peters CL, Shirley B, Erickson J. The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty. J Arthroplast. 2006;21(6):132–8.CrossRef
20.
Ranawat AS, Ranawat CS. Pain management and accelerated rehabilitation for total hip and total knee arthroplasty. J Arthroplast. 2007;22(7):12–5.CrossRef
21.
Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367(9522):1618–25.CrossRefPubMed
22.
Botti M, Kent B, Bucknall T, Duke M, Johnstone M-J, Considine J, Redley B, Hunter S, de Steiger R, Holcombe M. Development of a Management Algorithm for Post-operative Pain (MAPP) after total knee and total hip replacement: study rationale and design. Implement Sci. 2014;9(1):110.CrossRefPubMedPubMedCentral
23.
Jensen MP, Karoly P, O’Riordan EF, Bland Jr F, Burns RS. The subjective experience of acute pain. An assessment of the utility of 10 indices. Clin J Pain. 1989;5(2):153–9.CrossRefPubMed
24.
Bucknall T, Manias E, Botti M. Acute pain management: implications of scientific evidence for nursing practice in the postoperative context. Int J Nurs Pract. 2001;7(4):266–73.CrossRefPubMed
25.
Husni ME, Losina E, Fossel AH, Solomon DH, Mahomed NN, Katz JN. Decreasing medical complications for total knee arthroplasty: effect of critical pathways on outcomes. BMC Musculoskelet Disord. 2010;11(1):160.CrossRefPubMedPubMedCentral
26.
Kim S, Losina E, Solomon DH, Wright J, Katz JN. Effectiveness of clinical pathways for total knee and total hip arthroplasty. J Arthroplast. 2003;18(1):69–74.CrossRef
27.
Dy SM, Garg P, Nyberg D, Dawson PB, Pronovost PJ, Morlock L, Rubin H, Wu AW. Critical pathway effectiveness: assessing the impact of patient, hospital care, and pathway characteristics using qualitative comparative analysis. Health Serv Res. 2005;40(2):499–516.CrossRefPubMedPubMedCentral
28.
Florin J, Ehrenberg A, Ehnfors M. Clinical decision-making: predictors of patient participation in nursing care. J Clin Nurs. 2008;17(21):2935–44.CrossRefPubMed
29.
Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39(4 Pt 1):1005–26.CrossRefPubMedPubMedCentral
30.
Hibbard J, Cunningham P. How engaged are consumers in their health and health care, and why does it matter? HSC Research Brief. 2008;8:1–9.PubMed
31.
Degner LF, Sloan JA, Venkatesh P. The control preferences scale. Can J Nurs Res. 1997;29(3):21–43.PubMed
32.
Gordon DB, Polomano RC, Pellino TA, Turk DC, McCracken LM, Sherwood G, Paice JA, Wallace MS, Strassels SA, Farrar JT. Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. J Pain. 2010;11(11):1172–86.CrossRefPubMed
33.
Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003;3(4):310–6.CrossRefPubMed
34.
Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996;78(2):185–90.PubMed
35.
Takeuchi R, Sawaguchi T, Nakamura N, Ishikawa H, Saito T, Goldhahn S. Cross-cultural adaptation and validation of the Oxford 12-item knee score in Japanese. Arch Orthop Trauma Surg. 2011;131(2):247–54.CrossRefPubMed
36.
Dunbar MJ, Robertsson O, Ryd L, Lidgren L. Translation and validation of the Oxford-12 item knee score for use in Sweden. Acta Orthop. 2000;71(3):268–74.CrossRef
37.
Williams D, Blakey C, Hadfield S, Murray D, Price A, Field R. Long-term trends in the Oxford knee score following total knee replacement. Bone Joint J. 2013;95(1):45–51.CrossRefPubMed
38.
Grant A, Treweek S, Dreischulte T, Foy R, Guthrie B. Process evaluations for cluster-randomised trials of complex interventions: a proposed framework for design and reporting. Trials. 2013;14(1):15.CrossRefPubMedPubMedCentral
39.
Dihle A, Bjolseth G, Helseth S. The gap between saying and doing in postoperative pain management. J Clin Nurs. 2006;15(4):469–79.CrossRefPubMed
40.
41.
Dunwoody CJ, Krenzischek DA, Pasero C, Rathmell JP, Polomano RC. Assessment, physiological monitoring, and consequences of inadequately treated acute pain. J Perianesth Nurs. 2008;23(1):S15–27.CrossRefPubMed
42.
Pagé MG, Katz J, Escobar EMR, Lutzky-Cohen N, Curtis K, Fuss S, Clarke HA. Distinguishing problematic from nonproblematic postsurgical pain: a pain trajectory analysis after total knee arthroplasty. Pain. 2015;156(3):460–8.CrossRefPubMed
43.
Visser EJ. Chronic post-surgical pain: epidemiology and clinical implications for acute pain management. Acute Pain. 2006;8(2):73–81.CrossRef
44.
McTier LJ, Botti M, Duke M. Patient participation in quality pain management during an acute care admission. Clin J Pain. 2014;30(4):316–23.CrossRefPubMed
45.
Payne R, Harding S, Murray D, Soutar D, Baird D, Glaser A, Welham S, Gilmour A, Thompson RS, Webster R. The Guide to GenStat Release 14, Part 2: Statistics. United Kingdom (UK): VSN International; 2011.
46.
47.
Neuendorf KA. The content analysis guidebook. Michigan, USA: Sage; 2002.
Metadata
Title
Patient participation in postoperative care activities in patients undergoing total knee replacement surgery: Multimedia Intervention for Managing patient Experience (MIME). Study protocol for a cluster randomised crossover trial
Authors
Jo McDonall
Richard de Steiger
John Reynolds
Bernice Redley
Patricia Livingston
Mari Botti
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1133-5

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue

Research article

Digital anatomical measurements and crucial bending areas of the fixation route along the inferior border of the arcuate line for pelvic and acetabular fractures

Research article

Scoliosis epidemiology is not similar all over the world: a study from a scoliosis school screening on Chongming Island (China)

Study protocol

The STAP-study: The (cost) effectiveness of custom made orthotic insoles in the treatment for plantar fasciopathy in general practice and sports medicine: design of a randomized controlled trial

Research article

The impact of depression among chronic low back pain patients in Japan

Research article

Barriers and facilitators to disease-modifying antirheumatic drug use in patients with inflammatory rheumatic diseases: a qualitative theory-based study

Research article

Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain