Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing


Post-operative pain control for patients undergoing total hip replacement (THR) and total knee replacement (TKR) continues to present a dilemma for providers and patients, decreasing mobility and increasing the risk of adverse outcomes (Kremers, et al., 2013). There is little research on the effect of common symptom self-management strategies implemented postoperatively for THR and TKR patients (Fredericks, Guruge, Souraya, & Wan, 2010). In addition to the lack of research on the use of symptom-self management, few post-operative pain control studies have been conducted with the elderly population (Laforest etal., 2008).

The purpose of this pilot project was to implement postoperative education in a select population of elderly patients undergoing THR or TKR in combination with the pre-operative education which was standard of care at the site. The primary endpoints were to improve selfefficacy over the course of the intervention period and to decrease pain in the population.

The study design was a descriptive report to report pain scores, self-efficacy scores, and related demographics in a sample of elders who elected to participate in the post-operative educational intervention. A randomly selected retrospective group was analyzed for pain scores and demographics for comparison.

The data were analyzed using Statistical Analysis Software (SAS) version 9.3. Pearson’s correlations compared pain scores and Pain Self-Efficacy Questionnaire (PSEQ) scores. The results suggested a negative correlation between pain scores and self-efficacy scores; that is, as self-efficacy scores increased, pain scores tended to decrease.

PSEQ scores were compared at multiple points using the paired t-test. A statistically significant difference was seen in scores between pre-procedure and post-procedure scores at both 24 and 48 hours post-discharge. PSEQ scores increased at each time point.

Average pain scores for the inpatient stay were compared between the intervention group and the retrospective comparison group. Pain scores in the intervention group were slightly lower overall, but no statistically significant difference in pain scores was found.

These results suggest that in this group a post-operative educational intervention may increase self-efficacy in older adults undergoing THR or TKR.