Pre-operative Education for Total Knee Replacement: A Pilot Survey

Abstract Purpose: The structure of pre-operative education programs used nationally for patients prior to total knee replacement (TKR) surgery has not been identified previously, thus hospitals across the United States lack a common standard for this pre-operative education to ensure best patient outcomes. The purpose of this pilot survey study was to describe the content, providers, and delivery methods currently utilized to deliver pre-operative education for total knee replacement in the United States. Method: Data were collected using an online survey developed by the authors based on review of literature and three pre-operative programs, and was distributed through the Research Electronic Data Capture (REDCap). The survey consisted of 16 questions, including 12 closed-ended and four open-ended items. Participants were identified through convenience sampling using contacts of the first author and an internet search of hospitals that provide pre-operative education. Seven professional participants total from nursing, physical therapy, and occupational therapy completed the survey. Descriptive statistics were used for data analysis of the 12 quantitative questions to determine frequency and percentages of responses. Responses on the four open-ended survey items, as well as participant responses of “other” for question items, were recorded and collated from individual survey responses. Results: Pre-operative education provider teams for total knee replacements most frequently consisted of nursing, physical therapy, and occupational therapy staff. Most education programs were provided two weeks prior to surgery in a group format, with the majority of programs being delivered in a single session lasting between 1 and 1.5 hours. Verbal and written instruction were the most commonly utilized methods to deliver education. Individual patient programs included a variety of topics, ranging from what to expect while in the hospital, self-care, adaptive equipment, and home safety being some of the most commonly included content. Conclusions: This pilot study provides a framework to describe the structure of pre-operative total knee replacement education nationally, and can be used to guide a future large scale survey to fully describe the content, providers, and delivery methods of pre-operative education for this population across the United States using a representative sample. Author Bio(s) Renee Causey-Upton, PhD, OTD, OTR/L, has a PhD in Rehabilitation Sciences from University of Kentucky. She is an assistant professor and the Bachelor of Science in Occupational Science Program Coordinator for the Department of Occupational Science and Occupational Therapy at Eastern Kentucky University. Dana M. Howell, PhD, OTD, OTR/L, FAOTA, has a PhD in Education from the University of Idaho and is a full professor in the Department of Occupational Science and Occupational Therapy at Eastern Kentucky University. She is also the Occupational Therapy Doctorate Program Coordinator at Eastern Kentucky University and Rehabilitation Sciences Doctoral program Liaison at University of Kentucky. Patrick H. Kitzman, PT, PhD, has a PhD in Neurosciences from the Ohio State University and is a full professor in the Department of Rehabilitation Sciences at the University of Kentucky. He also serves as the Associate Dean for Research in the College of Health Sciences at the University of Kentucky. Melba Custer, PhD, OT/L, has a PhD in Rehabilitation Sciences from University of Kentucky and is a professor in the Department of Occupational Therapy at Spalding University. She is also an occupational therapist at Commonwealth Hand Therapy. Emily V. Dressler, PhD, has her PhD in Biostatistics from the Medical University of South Carolina and is currently an associate professor in the Department of Biostatistical Sciences at Wake Forest School of Medicine. Acknowledgements The authors would like to thank the health care providers who were willing to participate in this pilot survey