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Randomized Clinical Trial Testing Efficacy of a Nurse-Coached Intervention in Arthroscopy Patients

Jones, Dorothy; Duffy, Mary E.; Flanagan, Jane

doi: 10.1097/NNR.0b013e3182002e46
Features

Background: Emerging data suggest limited patient preparation for ambulatory surgery, decreased access to healthcare providers postoperatively, increased patient and family anxiety, and increased patient suffering. Thus, there is a need for nursing interventions to improve the postoperative experience for patients and families.

Objective: The purpose of this study was to test the hypothesis that ambulatory arthroscopic surgery patients who receive a nurse-coached telephone intervention will have significantly less symptom distress and better functional health status than a comparable group who receive usual practice.

Methods: The study sample in this randomized clinical trial with repeated measures was 102 participants (52 in the intervention group and 50 in the usual practice group) drawn from a large academic medical center in the Northeast United States. Symptom distress was measured using the Symptom Distress Scale, and functional health was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey General Health Perceptions and Mental Health subscales.

Results: Multivariate analysis of covariance, with three repeated measures of the Symptom Distress Scale (baseline, 72 hours postsurgery, and 1 week postsurgery) and five covariates, was used to test the hypothesis. After removal of the covariate influence, intervention participants had significantly less symptom distress at 72 hours and 1 week postsurgery and significantly better overall physical and mental health at 1 week postsurgery than those who received usual practice.

Discussion: The findings suggest that telephone calls from nurses during the immediate postoperative period resulted in improved patient outcomes, namely, less symptom distress and better physical and mental health states. In future research, the study sample should be expanded to older and more diverse patients.

Dorothy Jones, EdD, FAAN, is Professor, Boston College Connell School of Nursing, Chestnut Hill, Massachusetts, and Director, Yvonne Munn Center for Nursing Research, Massachusetts General Hospital, Boston.

Mary E. Duffy, PhD, FAAN, is Senior Nurse Scientist, Yvonne Munn Center for Nursing Research, Massachusetts General Hospital, Boston, and Professor Emeritus, Boston College Connell School of Nursing, Chestnut Hill, Massachusetts.

Jane Flanagan, PhD, ANP-BC, is Assistant Professor, Boston College Connell School of Nursing, Chestnut Hill, Massachusetts.

Accepted for publication September 20, 2010.

The authors thank the faculty, specifically Jean O'Neil and Nancy Fairchild, and the students of Boston College Connell School of Nursing as well as the staff of the Pre-Admission Clinic and Same Day Surgery Unit of Massachusetts General Hospital who assisted with this project.

Funding was received from the National Institutes of Health, the National Institute of Nursing Research (grant no. 1RN15 NR05174-01A1).

Corresponding author: Dorothy Jones, EdD, FAAN, Connell School of Nursing, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA 02467 (e-mail: jones@bc.edu).

© 2011 Lippincott Williams & Wilkins, Inc.