Telenursing and transitional care after lumbar disc herniation surgery: A new paradigm for postoperative care

The aim of this thesis is to evaluate the effectiveness of telenursing and mobile health application (LumCARE) on post-discharge anxiety risk, fear of falling, mobility level, complication development rate, recovery rate, hospital admission, and readmission rates in patients who underwent Lumbar Disc Herniation (LDH) surgery. This randomized and quasi-experimental study was conducted between December 2024 and May 2025. A total of 107 patients (Study Group: 53, Control Group: 54) who met the inclusion criteria were included in the study from four different health centers in Gaziantep and Kahramanmaraş provinces. Data were collected through face-to-face interviews and hospital information systems. Ethical committee approval and written informed consent from all patients were obtained for the conduct of the study. Data collection tools included the Demographic Information Form, Patient and Observer Mobility Scale, Hospital Anxiety and Depression Scale (HAD), International Fall Effectiveness Scale (FES-I), Post-Discharge Surgical Recovery Scale, and Visual Comparison Scale. Informative content, exercise videos, and notifications were provided to patients through a mobile health application (LumCARE) prepared in line with transitional care principles; follow-up was provided through video calls and home visits within the first five days after discharge and weekly phone calls for four weeks as part of telenursing. Research data were collected 24 hours before discharge (T1), at the end of the first week after discharge (T2), between the end of the first week and the end of the first month after discharge (T3), and at the end of the first month after discharge (T4). At T1, the Demographic Information Form, Patient and Observer Mobility Scale, and HAD Scale were completed. At T2 and T3, information on complication development and hospital readmission was obtained from the hospital information management system for patients who came for follow-up visits. At the T4 measurement, the Patient and Observer Mobility Scale, HAD Scale, FES-I, and Post-Discharge Surgical Recovery Scale were completed. The satisfaction of patients in the study group regarding telenursing services was evaluated using the Visual Analog Scale. According to the research findings, transitional care-based telenursing and the LumCARE application significantly reduced anxiety risk and fear of falling, increased mobilization levels, decreased surgery-related complication rates, reduced readmission rates, and improved post-discharge recovery levels in patients who underwent LDH surgery (p<0.05). Transitional care-based telenursing and mHealth monitoring were found to be an effective approach in reducing fear of falling, surgery-related complication rates, readmission rates, anxiety risk, and improving mobility levels and post-discharge recovery levels in patients who underwent LDH surgery.