The Effect of Preoperative Video-assisted Patient Education on Postoperative Activities of Daily Living and Quality of Life in Patients with Femoral Fracture

J Clin Exp Invest 2020;11(2):em00736.

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Objectives: The aim of study was to determine the effect of preoperative education on the postoperative activities of daily living and quality of life (QoL) of patients with trochanteric femoral fracture (TFF) treated with internal fixation.
Materials and methods: The patients were included those treated for TFF at an orthopaedic clinic in western Turkey between March and July 2014 in this randomised controlled study. The study was conducted in accordance with the Helsinki Declaration and was approved by the Ethics Committee of our university. The 56 patients were randomly divided into two groups. The intervention group was included in a preoperative education programme which is consisting of video-assisted oral presentation and education booklet, 1 day before surgery. At the end of education, one each sample of booklet and video were given to patients. The control group was informed with only routine clinical information by nurses. Data were collected using patient information form, Barthel Index (BI), Harris Hip Score (HHS) and Short-Form Health Survey (SF-36). Descriptive statistics, Student’s t-test, the Mann-Whitney U test, and a chi-square test were used to evaluate the data.
Results: Age, sex, educational level and length of hospital stay were similar in both groups (p>0.05). Total HHS, BI, and SF-36 scores at 1 and 3 months postoperatively were higher the intervention group than the control group (p<0.05).
Conclusion: Video-assisted preoperative education improves QoL and activities of daily living, in patients with TFF treated by nailing. An education programme like this could be useful for all surgical clinics.


activities of daily living, patient education, quality of life, femoral fractures, videotape


  • Ebrahimi H, Ashrafi Z, Rudsari DM, Parsayekta Z, Haghani H. Effect of family-based education on the quality of life of persons with type 2 diabetes: A randomized clinical trial. J Nurs Res. 2018;26(2):97-103. doi: 10.1097/jnr.0000000000000212.
  • Peeters CM, Visser E, Van de Ree CL, Gosens T, Den Oudsten BL, De Vries J. Quality of life after hip fracture in the elderly: A systematic literature review. Injury. 2016;47(7):1369-8 doi: 10.1016/j.injury.2016.04.018.
  • Haines TP, Russell T, Brauer SG, Erwin S, Lane P, Urry S, Jasiewicz J, Condie P. Effectiveness of a video-based exercise programme to reduce falls and improve health-related quality of life among older adults discharged from hospital: A pilot randomized controlled trial. Clinical Rehabilitation. 2009;23(11):973-85. doi: 10.1177/0269215509338998
  • Leal J, Gray AM, Hawley S,et al. Cost‐Effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: A population‐based study. J Bone Miner Res. 2017;32(2):203-11. doi: 10.1002/jbmr.2995.
  • Sinclair PM, Kable A, Levett-Jones T, Booth D. The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: a systematic review. Int J Nurs Stud. 2016;57:70-81. doi: 10.1016/j.ijnurstu.2016.01.011.
  • Sadegh Tabrizi J, Seyedhejazi M, Fakhari A, Ghadimi F, Hamidi M, Taghizadieh N. Preoperative education and decreasing preoperative anxiety among children aged 8-10 years old and their mothers. Anesth Pain Med. 2015;5(4):e2503 doi: 10.5812/aapm.25036
  • Hoppe DJ, Denkers M, Hoppe FM, Wong IH. The use of video before arthroscopic shoulder surgery to enhance patient recall and satisfaction: a randomized-controlled study. J Shoulder Elbow Surg. 2014;23(6):e134-9. doi: 10.1016/j.jse.2013.09.008.
  • Klemetti S, Leino-Kilpi H, Cabrera E, et al. Difference between received and expected knowledge of patients undergoing knee or hip replacement in seven European countries. Clin Nurs Res. 2015;24(6):624-43. doi: 10.1177/1054773814549992.
  • Zieren J, Menenakos C, Mueller JM. Does an informative video before inguinal hernia surgical repair influence postoperative quality of life? Results of a prospective randomized study. Quality of Life Research. 2007;16(5):725- doi:10.1007/s11136-007-9171-y
  • Yildiz T. Current methods used in surgery patient education: Not disease centered, patient centered education. Clinical and Experimental Health Sciences. 2015;5(2):129-33. doi:5455/musbed.20150125115949
  • Ihrig A, Herzog W, Huber CG, Hadaschik B, Pahernik S, Hohenfellner M, Huber J. Multimedia support in preoperative patient education for radical prostatectomy: The physicians’ point of view. Patient education and counseling. 2012;87(2):239-42. doi: 10.1016/j.pec.2008.014.
  • Abed MA, Himmel W, Vormfelde S, Koschack J. Video-assisted patient education to modify behavior: a systematic review. Patient education and counseling. 2014;97(1):16-22. doi: 10.1016/j.pec.2014.06.015
  • Fahey N, Patel V, Rosseau G. A comparative analysis of online education resources for patients undergoing endoscopic transsphenoidal surgery. World Neurosurgery. 2014;82(6):e671-5. doi: 10.1016/j.wneu.2014.09.014
  • Erdogan Z, Bulut H. Effectiveness of Computer Assisted Training of Patients Undergoing Lumbar Disc Herniation Surgery. Turkish Neurosurgery. 2019. doi: 10.5137/1019-5149.JTN.26775-19.2
  • Zhang Y, Ruan X, Tang H, Yang W, Xian Z, Lu M. Video-assisted informed consent for cataract surgery: a randomized controlled trial. Journal of Ophthalmology. 2017; Article ID 9593631, 6 pages doi: 10.1155/2017/9593631
  • Cornoiu A, Beischer AD, Donnan L, Graves S, de Steiger R. Multimedia patient education to assist the informed consent process for knee arthroscopy. ANZ journal of surgery. 2011;81(3):176-80. doi: 10.1111/j.1445-2197.2010.05487.x
  • Sonne SC, Andrews JO, Gentilin SM, Oppenheimer S, Obeid J, Brady K, Wolf S, Davis R, Magruder K. Development and pilot testing of a video-assisted informed consent process. Contemporary clinical trials. 2013;36(1):25-31. doi: 10.1016/j.cct.2013.05.011
  • Beamond BM, Beischer AD, Brodsky JW, Leslie H. Improvement in surgical consent with a preoperative multimedia patient education tool: a pilot study. Foot & ankle international. 2009;30(7):619-26. doi: 10.3113/FAI.2009.0619
  • Sendir M, Babadag K. The effect of patient education prior to hip replacement surgery on postoperative physical compliance and quality of life. Nursing Bulletin 2000; 12(46): 27-42.
  • Kucukdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 2000;32(2):87-92.
  • Celik D, Can C, Aslan Y, Kerem B, Razak Ozdincler A. Translation and cultural adaptation of harris hip score into the Turkish. IN: XIVTH Development of Physıotherapy Congress Abstracts of Oral Presentatıons and Posters. Turkish J of Physiotherapy Rehabilitation. 2021;23(1):82.
  • Kocyigit, H. Reliability and validity of the Turkish version of short form-36 (SF-36): a study in a group of patients will rheumatic diseases. Turk J Drugs Ther. 1999;12:102-6.
  • Maisongrosse P, Lepage B, Cavaignac E, et al. Obesity is no longer a risk factor for dislocation after total hip arthroplasty with a double-mobility cup. Int Orthop. 2015;39(7):1251-8. doi: 10.1007/s00264-014-2612-7.
  • Cheung WH, Shen WY, Dai DL, et al. Evaluation of a multidisciplinary rehabilitation programme for elderly patients with hip fracture: A prospective cohort study. J Rehabil Med. 2018;50(3):285-91. doi: 10.2340/16501977-2310.
  • Sprague S, BhandariM, Heetveld MJ, Liew, et al. Factors associated with health-related quality of life, hip function, and health utility after operative management of femoral neck fractures. Bone Joint J. 2018;100(3):361-9. doi: 10.1302/0301-620X.100B3.BJJ-2017-0853.R1.
  • Cawsey S, Padwal R, Sharma AM, Wang X, Li S, Siminoski K. Women with severe obesity and relatively low bone mineral density have increased fracture risk. Osteoporos Int. 2015;26(1):103-111. doi: 10.1007/s00198-014-2833-z.
  • Liu LK, Lee WJ, Chen LY, et al. Association between frailty, osteoporosis, falls and hip fractures among community-dwelling people aged 50 years and older in Taiwan: results from I-Lan Longitudinal Aging Study. PLoS One. 2015;10(9):e0136968. doi: 10.1371/journal.pone.0136968.
  • Wang O, Hu Y, Gong S, Xue Q, et al. A survey of outcomes and management of patients post fragility fractures in China. Osteoporos Int. 2015;26(11):2631-40. doi: 10.1007/s00198-015-3162-6.
  • Hartford JM, Knowles SB. Risk factors for perioperative femoral fractures: cementless femoral implants and the direct anterior approach using a fracture table. J Arthroplasty. 2016;31(9):2013-8. doi: 10.1016/j.arth.2016.02.045.
  • Sahin EK, Imerci A, Kınık H, Karapınar L, Canbek U, Savran A. Comparison of proximal femoral nail antirotation (PFNA) with AO dynamic condylar screws (DCS) for the treatment for unstable peritrochanteric femoral fractures. Eur J Orthop Surg Traumatol. 2014;24(3):347-52. doi: 10.1007/s00590-013-1195-0.
  • Kiyota T, Fujiwara K. Dominant side in single-leg stance stability during floor oscillations at various frequencies. J Physiol Anthropol. 2014;33:25. doi: 10.1186/1880-6805-33-25.
  • Ronco M, Iona L, Fabbro C, Bulfone G, Palese A. Patient education outcomes in surgery: a systematic review from 2004 to 2010. Int J Evid Based Healthc. 2012;10(4):309-23. doi: 10.1111/j.1744-1609.2012.00286.x.
  • Tseng MY, Liang J, et al. Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial. BMC Musculoskelet Disord. 2016;17(1):114. doi: 10.1186/s12891-016-0958-2.
  • Siggeirsdottir K, Olafsson O, Jonsson H, Iwarsson S, Gudnason V, Jonsson BY. Short hospital stay augmented with education and home-based rehabilitation improves function and quality of life after hip replacement: randomized study of 50 patients with 6 months of follow-up. Acta Orthop. 2005 ;76(4):555-62.
  • Crabtree TD, Puri V, Bell JM, et al. Outcomes and perception of lung surgery with implementation of a patient video education module: a prospective cohort study. J Am Coll Surg. 2012;214(5):816-821.e2. doi: 10.1016/j.jamcollsurg.2012.01.047.
  • Gold M, Dunn LB, Phoenix B, Paul SM, Hamolsky D, Levine JD, Miaskowski C. Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life. Eur. J. of Oncology Nurs. 2016;20:97-105. doi: 10.1016/j.ejon.2015.06.003
  • González-Zabaleta J, Pita-Fernandez S, Seoane-Pillado T, López-Calviño B, Gonzalez-Zabaleta JL. Dependence for basic and instrumental activities of daily living after hip fractures. Arch Gerontol Geriatr. 2015;60(1):66-70. doi: 10.1016/j.archger.2014.10.020.
  • de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res. 2008;466(9):2201-8. doi: 10.1007/s11999-008-0315-3.
  • Czyżewska A, Glinkowski WM, Walesiak K, Krawczak K, Cabaj D, Górecki A. Effects of preoperative physiotherapy in hip osteoarthritis patients awaiting total hip replacement. Arch Med Sci. 2014 ;10(5):985-91. doi: 10.5114/aoms.2014.46218.


Peker SV, Yılmaz E, Baydur H. The Effect of Preoperative Video-assisted Patient Education on Postoperative Activities of Daily Living and Quality of Life in Patients with Femoral Fracture. J Clin Exp Invest. 2020;11(2):em00736.