Investigation of the effect of education and counseling provided through telenursing service on postoperative quality of life and complications after total knee arthroplasty

This study was conducted to examine the effect of education and counseling provided through tele-nursing services after total knee replacement on postoperative quality of life and complications. The study was conducted as a randomized, controlled, quasi-experimental clinical trial. Data were collected from 90 patients who underwent total knee arthroplasty between October 2023 and February 2025. Patients were assigned to the study and control groups using a simple randomization method. The study group received counseling through a tele-nursing application after total knee replacement discharge, while the control group received routine nursing care. Data were collected using the Patient Information Form, Oxford Knee Score, EQ-5D-5L Quality of Life Scale, Visual Analog Scale (VAS), Weekly Follow-up Data Form, and Tele-Nursing Service Satisfaction Evaluation Form. Both the study and control groups received a written copy of the Post-Discharge Home Care Brochure, as well as an audio version of the brochure sent to their smartphones via WhatsApp. Patients were followed up before surgery and during the first, second, third, fourth, and sixth weeks after discharge. Data were analyzed using the R program. Statistical significance was set at p<0.05. Patients were similar in terms of demographic and disease characteristics (p>0.05). It was determined that preoperative EQ-5D-5L scores were similar in the study and control groups, and there was no difference in scores at weeks 4 and 6 (p>0.05). The Oxford Knee Score was found to be similar in the study and control groups before surgery, but statistically different at weeks 4 and 6 (p<0.05). In the study group, the average pain score according to VAS was 7.64±0.88 at week and 0.78±0.88 at week 6. When evaluated for DVT complications after discharge, no patients were identified in the third week in the study group, while deep vein thrombosis developed in 26.7% of patients in the control group, and this difference was found to be statistically significant (p<0.001). Surgical wound infection complications were observed at a higher rate in the control group in the second and third weeks, and in terms of readmission, no readmissions were observed in the study group in the second and third weeks, while 15.6% of patients in the control group were readmitted, and this difference was found to be statistically significant (p<0.001). Most patients who wanted to receive information by phone were in the control group (48.9%), and the topics they wanted information about were, in order, medication use in the study group: 65%; control group: 55.1%, wound care in the study group: 40%; control group: 28.6%, exercise in the study group: 35%; control group: 28.6%, and pain management in the study group: 30%; control group: 28.6%. The satisfaction rate of the working group with the telenursing service is 100%. It was concluded that the education and counseling provided to patients who underwent TDP through tele-nursing after discharge was effective in managing pain and complications. Keywords: education, post-discharge counseling, surgical nursing, total knee replacement, telenursing,