Sustained Effects of a Peplau-Based Anxiety Reduction Program in Total Knee Replacement Patients: A Repeated Measures Study

Abstract

Background: This study evaluates the effectiveness of a Peplau-based anxiety reduction program (PARP) in alleviating anxiety levels at three time points: before intervention (T1), after intervention (T2), and on the morning of surgery (T3).

Methods: A quasi-experimental study was conducted with 27 total knee replacement (TKR) patients receiving PARP a day before surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI) form Y-1 at T1, T2, and T3. Statistical differences were analyzed using the Friedman Test and Wilcoxon Signed Ranks Test.

Results: Anxiety levels significantly decreased post-intervention and remained lower on the morning of surgery. The Friedman Test indicated significant differences between T1, T2, and T3 (χ²(2) = 54.000, p < .001). Wilcoxon Signed Ranks Test showed anxiety at T2 was significantly lower than T1 (Z = -4.543, p < .001), and anxiety at T3 was significantly lower than both T1 (Z = -4.545, p < .001) and T2 (Z = -4.549, p < .001).

Conclusion: PARP effectively reduced anxiety levels in TKR patients at all measured time points, highlighting its potential as a valuable preoperative psychological preparation strategy. Implications: Integrating PARP into preoperative care can enhance patient well-being, nursing education, and policy development by improving patient education, training, and quality improvement initiatives.

Suggestions: Future research should explore the program’s generalizability, optimize its components, assess long-term outcomes, and evaluate feasibility in standard care protocols. A cost-benefit analysis is recommended to determine its economic viability compared to other anxiety reduction strategies.