Evaluation of the efficacy of the transitional care model on functional status, self-efficacy, and health care utilization in arthroplasty patients

Today, aging population, increasing obesity rates, sedentary lifestyle due to chronic diseases increase the importance of osteoarthritis. The transitional care model has become an important aspect of patient care in the health system, especially due to the increase in the post-discharge care needs of elderly and fragile patients. This study is a clinical randomized controlled trial conducted between February 2021 and November 2021 to determine the effectiveness of telehealth-based transitional care in patients with total knee arthroplasty on patients' functional status, self-efficacy perception and health care use. The participants of the study consisted of patients who were admitted to the Orthopedics and Traumatology Surgery Clinic of a hospital providing tertiary health care to undergo total knee arthroplasty. Patients were assigned to the control (n=35) and experimental (n=35) groups using the block randomization method. The experimental group received transitional care, while the control group received standard care. Time-dependent changes in patient outcomes (pre-surgery, 2 and 9 weeks after discharge) were evaluated using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and ASES (Arthritis Self-efficacy Scale) scales. It was questioned whether the patients applied to the hospital in the 2nd, 6th, 9th week and 3rd month after discharge. Participants in the intervention group (WOMAC=T2:53.60, T3:31.09; ASES=T2:129.69, T3:161.00) compared to the control group (WOMAC=T2:67.97, T3:42.97; ASES=T2:110.29, T3:138.51) showed significantly greater improvement in functional status and perception of self-efficacy (p<0.05). In addition, it was observed that the rate of admission to the hospital in the experimental group was lower than that of the control group, and a statistically significant difference was observed in the measurement at the 6th week (p<0.05). It was determined that there was a significant improvement in the functional status and self-efficacy perceptions of arthroplasty patients who underwent transitional care, and that the rate of admission to the hospital also decreased. This result shows that the application of the transitional care model in patients with total knee arthroplasty should be encouraged. Keywords: Transitional Care, Transitional Nursing, Knee Arthroplasty, Randomized Study