The Effect of Empowerment Program on the Self-Efficacy and Pain Control in the Patients under Arthroplasty referred to Tabriz Medical Centers 2016.
چکیده
Abstract:: Background and objectives: The knee replacement surgery, following
knee osteoarthritis, is a treatment method for patients with
osteoarthritis. It is associated with significant effects on limited range
of motion from two perspectives: self-efficiency and motor function.
Therefore, the improvement of pain and self-efficacy indices is very
important. The aim of this study was to assess the effect of
empowerment program on the self-efficacy and pain control in the
patients under arthroplasty.
We aimed to evaluate the effectiveness of empowerment on the pain
control and self-efficacy of the patients undergoing total knee
arthroplasty.
Material and methods: This Randomized Clinical Trial was conducted
on 98 patients hospitalized in the orthopedic department of Shohada and
Shahid Mahallati Hospitals in 2016. The eligible patients were selected
through convenience sampling then allocated into the intervention and
control groups with a ratio of 1:1 using a randomized complete block
design with four factors in RAS. First, the degrees of pain and self-efficacy in both groups were measured. Then, an empowerment
program, based on Linton’s cognitive-behavioral model and Bandura's
self-efficacy theory, was administered to the intervention group through
individual training, group discussion, practical participation and control
group receive just routine-care. After intervention, pain and self-efficacy were measured again in order to collect the data with the short
form McGill pain and self-efficacy questionnaires. Data were analyzed
by SPSS software version 16.
Findings: The two groups were similar in terms of demographic
variables, baseline data of pain, and self-efficacy. The paired t-test
results for intra-group comparison showed that after the intervention in
the both groups, the subscales of pain (sensory-emotional components,
intensity and description of pain) decreased and self-efficacy
significantly increased (p<0.01). In addition, the independent t-test
results for between-group comparison (intervention and control)
showed no significant pre-intervention difference in terms of pain and
self-efficacy (p<0.05) but the post-intervention between-groups
comparison showed a significant difference in pain subscales as
follows: sensory-emotional components (p<0.01, difference mean=-
2.41; 95% CI=-3.86--0.96), intensity pain (p<0.01, difference mean=-
1.57; 95% CI=-2.12--1.01), and pain description (p<0.01, difference
mean=0.61; 95% CI=-1.04- -0.01). There was also a significant
between-groups difference in term of self-efficacy (p<0.01, difference
mean=0.98; 95% CI=0.71-1.24). The MANCOVA results showed that
the effect of intervention remained significant even after the removal of
confounding variables effect. In other words, between-groups
comparison suggested a lower degree of pain (p<0.05) and higher level
of self-efficacy in the intervention group after the implementation of
the empowerment program. Results showed that the administration of
the empowerment program for the intervention group could reduce
sensory-emotional component of pain by 11%, pain intensity by 33%,
and pain description by 18.5% of the baseline. In addition, it improved
self-efficacy in the intervention group by 286% of the baseline.
Conclusion: In regard with the results empowerment program in
patients 'undergoing TKA (total knee arthroplasty) as a feasible,
effective and noninvasive approach, can be helpful in improving pain
control and self-efficacy of patients