The Effects of the Empowerment Education Program in Older Adults With Total Hip Replacement Surgery

Background: Degenerative arthrits is not only a common disease, but also a serious chronic illness that impact the quality of life of older adults. While join degeneate continuingly and hip has been damaged by arthritis, it will lead to severe hip pain, joint stifness, and difficult to perform ADL. Therefore, hip replacement surgery should be considered, and effectively nursing care should be provided to improve their recovery.

Objects: To exam the effectiveness of the empowerment education program on primary (ADL, mobility and self-care ability) and secondary outcomes (depression, quality of life, and self-efficacy) for older adults with total hip replacement surgery.

Methods: The empowerment education program implements Freire’s3-stage methodology of listening, dialogue, and action problem-posing process which include: participation of both patients/family and nurses; the value of patients’ experience as contributing to knowledge about self-care after surgery; critical thinking with patients’ asking their own questions of themselves; and group dialogue to explore root causes and motivate patients to engage in creative action that address problems in their own. A randomized control trial was conducted in two hospitals in northern Taiwan. There were 108 participants randomly assigned to either empowerment education (EE) or the control group. The outcomes were collected at one month (T2), and at 3 months (T3), after the interventions.

Results: After the interventions, the EE group participants demonstrated significantly better self-care ability (p < .001), QOL (p < .01) and self-efficacy (p < .01), and lower depressive inclination (p < .05) than those in the control group. Also, participants in both groups were significantly improved over time on ADL and mobility (p < .001).

Conclusions: This EE intervention was quite effective in enhancing participants’ outcomes. However, the mean age of the participants was 65.42 years old, and 41.9% of them were over 65. Involving both elderly adults and their caregivers in participating this program is recommended for better impact.