The effect of a program based on the family-centered empowerment model on total knee prosthesis patients and their caregivers: Randomized controlled study

This study aimed to determine the effects of a family-centered empowerment model (FCEM) based program given to patients and caregivers who underwent total knee arthroplasty (TKA) on the individuals' physical function level and self-efficacy; and on the caregiver's care burden, caregiving competence, and stress coping.. The sample of this randomized controlled parallel group (1:1) study consisted of 62 patients and caregivers with TKA between December, 2023, and August, 2024. Patients were randomly divided into two groups as intervention and control groups. A program based on FCEM was applied to patients and caregivers in the intervention group. Patients and caregivers in the control group received routine care. After the follow-up test, the control group was also given an educational booklet. The research data were collected using the sociodemographic characteristics form, Modified Barthel Daily Living Activities, General Self-efficacy, Zarit Caregiving Burden, Caregiving Competence and Stress Coping Scale. Data were analyzed with IBM SPSS V23, Jamovi V2.3.28 and R programs. Robust ANOVA was used using the Walrus package to compare values that did not conform to normal distribution according to group and time, and Generalized Linear Model was used to compare values that conformed to normal distribution. There was a significant difference between the groups in the patients' Modified Barthel Activities of Daily Living Scale mobility subscale (F=8.85; p<0.05; ηp2=0.24); in the caregivers' Zarit Caregiver Burden Scale (F=44.0; p<0.001; ηp2=0.79) and in the Coping with Stress Scale scores (F=5.62; p<0.05; ηp2=0.06). However, no significant difference was found in the patients' Modified Barthel Activities of Daily Living Scale, General Self-efficacy Scale and the total scores of the caregivers' Caregiving Competence Scale (p>0.05). As a result, it was determined that patients who received FCEM program had better physical mobility, lower care burden of caregivers and higher levels of coping with stress. Self-efficacy and caregiving competence of the groups were similar. As a result of this research, it is recommended that the knowledge and awareness of the teams responsible for the treatment and care of TKA patients be increased regarding FCEM, and that longer follow-up studies be conducted to determine the long-term effects of the FCEM program. In addition, it is recommended that in-service training be organized for health professionals regarding the stress experienced by caregivers and post-discharge problems, and that services such as patient schools and telehealth be used.