Authors (including presenting author) :
Wong KS(1), Yu HY(1), Yu CY(2), Cheung YP (3), Yuen MH(1), Lam LY(1), Shek KY (4), FUNG MC (6), Ng WY (5)
Affiliation :
(1) Dept. of Orthopaedics & Traumatology, Tseung Kwan O Hospital, (2) Occupational Therapy Dept., Tseung Kwan O Hospital, (3) Nursing Service Division, Tseung Kwan O Hospital, (4) Dept. of Accident & Emergency, Tseung Kwan O Hospital, (5) Stoma & Wound & Care, Tseung Kwan O Hospital, (6) Community Nursing Services, Tseung Kwan O Hospital
Introduction :
In KEC Orthopaedic Joint Centre, TKR is a same day admission surgery serving 400 elderlies annually. Adequate perioperative education is essential to fluent preparation for surgery, decrease length of stay, prevent complication and speed up rehabilitation. Conventional paper pamphlet is the common media. With more elderly are adapting to smartphones, mobile health app becomes common in healthcare setting.
Objectives :
This EBP project aims to determine whether an educational mobile app for TKR patients can enhance patients’ perioperative self-care knowledge, improve psychological status and clinical outcome to those receiving pamphlets.
Methodology :
This is a RCT study. During August to December 2021, 60 patients were recruited. 32 in intervention group and 28 as control. Primary TKR patients using smart phones and able to use the mobile app, understand Traditional Chinese, with written consent were included. Patients who disagreed to install a mobile app, unable to use smart phone or app were excluded. Patients who received TKR before were excluded. Mobile health app was installed in intervention group while conventional pamphlet was given in control group. Depression, Anxiety and Stress Scale (DASS-21) and pain numeric rating score (NRS) and self-developed questionnaires were used to measure the effectiveness of these educational tools before and after TKR.
Result & Outcome :
Independent t-test showed anxiety level in DASS-21 was significantly improved in the intervention group. No significant difference in depression and stress level, pain level and length of stay. Perioperative education has been found in reducing preoperative anxiety across numeral systematic reviews. Findings in this study is consistent to previous studies. Increase accessibility to healthcare service through app can decrease anxiety level in coping in perioperative status. However, the length of stay, pain level at rest & exercise, DASS-21 stress and depression level did not show significant difference in both groups. Easy maintenance of content, timely access to information and case manager are advantage. Further influence of the mobile education app may depend on the quality and content of the app. The Joint Centre considered this is a successful implementation of new mobile health education app as an alternative to traditional pamphlet. Anxiety level is improved while other psychological outcome on stress, depression and knowledge level maintained.
