4-7-8 Breathing and Teach-Back Method for Pain, Anxiety, and Sleep After Knee Surgery: A Clinical Trial

NCT ID: NCT06912750

Last Updated: 2025-04-06

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-02-01
• Study Completion Date: 2025-12-30

Brief Summary

Total knee arthroplasty (TKA) is a surgical procedure performed to reduce pain and improve quality of life in elderly individuals with knee dysfunction due to osteoarthritis, rheumatoid arthritis, or other knee joint disorders. It is typically preferred in cases of advanced joint damage to help patients regain daily functional abilities. Postoperative rehabilitation is crucial for pain management, mobility, and overall recovery. The Teach-Back method is an effective educational technique that enhances patients' understanding of health information by encouraging them to repeat what they have learned. This approach improves information retention and promotes active participation in treatment, particularly among individuals with low health literacy. Complementary therapies, such as breathing exercises, can help manage common postoperative issues like pain, anxiety, and sleep disturbances. The 4-7-8 breathing technique has been shown to reduce anxiety and enhance sleep quality by regulating oxygen and carbon dioxide exchange. This method involves inhaling for four seconds, holding the breath for seven seconds, and exhaling for eight seconds, promoting physical and psychological relaxation.This study aims to evaluate the effects of 4-7-8 breathing exercises taught using the Teach-Back method on pain, anxiety, and sleep quality in patients undergoing total knee arthroplasty.

Detailed Description

Total knee arthroplasty (TKA) is a surgical intervention performed to alleviate pain and enhance quality of life in elderly individuals with impaired knee functionality due to osteoarthritis, rheumatoid arthritis, or other knee joint disorders. This procedure is primarily recommended in cases of advanced joint damage and aims to help patients regain their ability to perform daily activities. Postoperative rehabilitation plays a critical role in pain management, mobility improvement, and overall health recovery. The Teach-Back method is an effective educational strategy designed to enhance patients' comprehension of health-related information. This method ensures that patients accurately retain the information provided by healthcare professionals by requiring them to reiterate the learned content, thereby fostering active participation in their treatment process. Studies have demonstrated that this approach significantly improves information retention, particularly among individuals with low health literacy. Complementary therapies have been shown to be effective in managing common postoperative complications such as pain, anxiety, and sleep disturbances following TKA. Breathing exercises, in particular, have been found to reduce anxiety and improve sleep quality. Teaching breathing exercises through the Teach-Back method may contribute positively to the rehabilitation process by promoting both physical and psychological well-being. One such technique, the 4-7-8 breathing exercise, has been evidenced to aid in reducing anxiety and enhancing sleep quality. This technique involves inhaling for four seconds, holding the breath for seven seconds, and exhaling for eight seconds. By optimizing oxygen intake and facilitating the expulsion of carbon dioxide, this practice supports physiological and psychological relaxation. This study aims to evaluate the effects of 4-7-8 breathing exercises taught using the Teach-Back method on pain, anxiety, and sleep quality in patients undergoing total knee arthroplasty.

Conditions

Patients With Total Knee Arthroplasty

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: SINGLE

Study Groups

4-7-8 Breathing Exercise with Teach-Back Method

Group Type: EXPERIMENTAL

4-7-8 Breathing Exercise with Teach-Back Method

Intervention Type: OTHER

In the experimental group, patients will be provided with information regarding the purpose and significance of the 4-7-8 breathing technique using the Teach-Back method one day before surgery. To confirm comprehension, patients will be asked to repeat the information. The exercise will be demonstrated in a one-on-one session using the Teach-Back method, and patients will be guided through practical application. Following the training, patients will be instructed to perform the exercise independently, with the researcher monitoring its correct implementation. Each patient will be given a "4-7-8 Breathing Exercise Application Guide," which outlines the exercise steps based on relevant literature.

Before surgery, patients will complete the "Patient Information Form," the Visual Analog Scale (VAS) for pain, the State-Trait Anxiety Inventory (STAI), and the Richards-Campbell Sleep Questionnaire (RCSQ). Postoperatively, the VAS and STAI will be administered both before (pre-test) and after

Standard Postoperative Care

In the control group, patients will complete the "Patient Information Form," the Visual Analog Scale (VAS) for pain, the State-Trait Anxiety Inventory (STAI), and the Richards-Campbell Sleep Questionnaire (RCSQ) before undergoing total knee arthroplasty, without any additional interventions beyond standard clinical protocols.

Postoperatively, the VAS and STAI will be administered at the 6th, 12th, and 24th hours without any interventions. Following these assessments, patients will be asked to remain in a quiet and calm environment for 30 minutes. At the end of this period, the researcher will reassess pain and anxiety levels using the VAS and STAI, and the data will be collected. Additionally, at the 24th postoperative hour, the RCSQ will be administered, marking the conclusion of data collection for the control group.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

4-7-8 Breathing Exercise with Teach-Back Method

In the experimental group, patients will be provided with information regarding the purpose and significance of the 4-7-8 breathing technique using the Teach-Back method one day before surgery. To confirm comprehension, patients will be asked to repeat the information. The exercise will be demonstrated in a one-on-one session using the Teach-Back method, and patients will be guided through practical application. Following the training, patients will be instructed to perform the exercise independently, with the researcher monitoring its correct implementation. Each patient will be given a "4-7-8 Breathing Exercise Application Guide," which outlines the exercise steps based on relevant literature.

Before surgery, patients will complete the "Patient Information Form," the Visual Analog Scale (VAS) for pain, the State-Trait Anxiety Inventory (STAI), and the Richards-Campbell Sleep Questionnaire (RCSQ). Postoperatively, the VAS and STAI will be administered both before (pre-test) and after

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients who are conscious and oriented,
• Able to communicate,
• Age 65 and over,
• No cognitive-mental problems,
• Standard Mini Mental Test (SMMT) score of 24 and above,
• Have not attended a course on breathing exercises and yoga before,
• Patients who agree to participate in the study verbally and in writing

Exclusion Criteria

• Unconscious,
• Unable to communicate,
• Under 65 years of age

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Erzurum Technical University

OTHER

Sponsor Role: lead

Responsible Party

Yasemin Erden

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Yasemin Erden, Assistant Professor

Role: STUDY_DIRECTOR

Erzurum Technical University Faculty of Helath Science

Tülay Kılınç, Assistant Professor

Role: PRINCIPAL_INVESTIGATOR

Ataturk University Faculty of Nursing

Zeynep Bal

Role: PRINCIPAL_INVESTIGATOR

Firat University

Locations

Erzurum Techical University

Erzurum, Erzurum, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

02.16.23.01.2025

Identifier Type: -

Identifier Source: org_study_id