MATERIALS AND METHODS
Participants and sample size
Participants were patients after TKR, recruited
by convenience sampling from a university hospital in
the central region of Thailand between September and
December 2012. Patients who met the following inclusion
criteria were approached: (a) suffering from knee osteoarthritis, (b) undergoing TKR for the first time, (c) having
first follow-up following discharge, (d) being mentally
competent, and (e) being literate in Thai. The exclusion
criteria were (a) having a co-morbidity affecting functioning and mobility and (b) having history of psychoneurological abnormality.
The sample size was calculated using the Table
of Power Analysis of Polit and Beck15, with the level of
confidence (α) of 0.05. The power of test was 0.80, with
the effect size of 0.30. A sample size of 88 was necessary.
Instrument for assessments
Recovery symptoms were measured using the
Recovery Symptoms modified by the researcher from the
Activities of Daily Living Scale of the Knee Outcome
Survey16 and the Symptom Inventory.17 It was a 27-item
checklist with one open-ended questions. Using a scale
from 1 to 7, the subjects were asked to describe the
frequency with which given symptoms occurred during
the previous week. A total score was calculated by summing
the item scores. Higher scores indicated more severe symptoms. To determine the content validity of the instrument
in this study, the instrument was submitted to three
specialists at a university hospital who were experts in
caring for patients after TKR. The reliability in this study
was assessed by using Cronbach’s alpha and was found
to be 0.70.
Functional status was measured by using the
functional dimension of The Modified Thai WOMAC
(Western Ontario and McMaster University Osteoarthritis
Index).18 It is composed of 15 items arranged in a numeric
rating scale with the scores ranging from 0 to 10, to elicit
data regarding functional status of knee joints in different
postures. Higher scores reflected lower functional status.
Reliability in this study was assessed by using Cronbach’s
alpha and was found to be 0.87.
Data collection
Human subjects’ approval was obtained from the
Siriraj Institutional Review Board (Si 348/2012). Prior
to the start of data collection, the researcher contacted the
head nurse and other staff nurses of the orthopedics ward
and orthopedics clinic to ask for cooperation in the study.
Patients who met the inclusion criteria were approached
consecutively by the researcher on the day before their
operation and were invited to participate in the study.
Their informed consent was obtained. On the day of the
first follow-up after discharge from the hospital, while
TKR patients were waiting for the physician or when
the physician and nurse completed the routine procedure,
data collection was conducted by using the demographic
and clinical profile questionnaire, recovery symptoms
questionnaire, and functional dimension of The Modified
Thai WOMAC, respectively.
Data analysis
Demographic data and clinical profile were analyzed using descriptive statistics, and Pearson’s product
moment coefficient was employed to determine the relationships among age, BMI, and recovery symptoms, and
functional status in patients after TKR at first follow-up.
MATERIALS AND METHODS
Participants and sample size
Participants were patients after TKR, recruited
by convenience sampling from a university hospital in
the central region of Thailand between September and
December 2012. Patients who met the following inclusion
criteria were approached: (a) suffering from knee osteoarthritis, (b) undergoing TKR for the first time, (c) having
first follow-up following discharge, (d) being mentally
competent, and (e) being literate in Thai. The exclusion
criteria were (a) having a co-morbidity affecting functioning and mobility and (b) having history of psychoneurological abnormality.
The sample size was calculated using the Table
of Power Analysis of Polit and Beck15, with the level of
confidence (α) of 0.05. The power of test was 0.80, with
the effect size of 0.30. A sample size of 88 was necessary.
Instrument for assessments
Recovery symptoms were measured using the
Recovery Symptoms modified by the researcher from the
Activities of Daily Living Scale of the Knee Outcome
Survey16 and the Symptom Inventory.17 It was a 27-item
checklist with one open-ended questions. Using a scale
from 1 to 7, the subjects were asked to describe the
frequency with which given symptoms occurred during
the previous week. A total score was calculated by summing
the item scores. Higher scores indicated more severe symptoms. To determine the content validity of the instrument
in this study, the instrument was submitted to three
specialists at a university hospital who were experts in
caring for patients after TKR. The reliability in this study
was assessed by using Cronbach’s alpha and was found
to be 0.70.
Functional status was measured by using the
functional dimension of The Modified Thai WOMAC
(Western Ontario and McMaster University Osteoarthritis
Index).18 It is composed of 15 items arranged in a numeric
rating scale with the scores ranging from 0 to 10, to elicit
data regarding functional status of knee joints in different
postures. Higher scores reflected lower functional status.
Reliability in this study was assessed by using Cronbach’s
alpha and was found to be 0.87.
Data collection
Human subjects’ approval was obtained from the
Siriraj Institutional Review Board (Si 348/2012). Prior
to the start of data collection, the researcher contacted the
head nurse and other staff nurses of the orthopedics ward
and orthopedics clinic to ask for cooperation in the study.
Patients who met the inclusion criteria were approached
consecutively by the researcher on the day before their
operation and were invited to participate in the study.
Their informed consent was obtained. On the day of the
first follow-up after discharge from the hospital, while
TKR patients were waiting for the physician or when
the physician and nurse completed the routine procedure,
data collection was conducted by using the demographic
and clinical profile questionnaire, recovery symptoms
questionnaire, and functional dimension of The Modified
Thai WOMAC, respectively.
Data analysis
Demographic data and clinical profile were analyzed using descriptive statistics, and Pearson’s product
moment coefficient was employed to determine the relationships among age, BMI, and recovery symptoms, and
functional status in patients after TKR at first follow-up.
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