Relationships Among Self-Efficacy, Outcome Expectancy, and Postoperative Behaviors In Total Joint Replacement Patients

Abstract

PURPOSE: To determine whether self-efficacy and outcome expectancy predicted performance of postoperative leg exercises and ambulation among persons recovering from total hip or total knee replacement. DESIGN: Descriptive correlational. SAMPLE: 50 subjects recovering from their first unilateral total hip or total knee replacement at a large midwestern hospital who had completed a preoperative education course. METHODS: On postoperative day 1, subjects who correctly performed leg exercises and could properly ambulate with a walker were administered the Self-Efficacy Scale and the Outcome Expectancy Scale. On postoperative day 2, frequency and repetitions of leg exercises were measured by self-report. Ambulation was measured by distance walked in feet. FINDINGS: Self-efficacy was the sole predictor of the dependent variables, accounting for 8% to 33% of the variance. Higher levels of self-efficacy were correlated with longer distances in ambulation and with higher frequency and more repetitions of leg exercises. IMPLICATIONS FOR NURSING PRACTICE: Solely providing a preoperative education course is not sufficient to ensure performance of postoperative behaviors in total joint replacement patients. Patients' self-efficacy beliefs may need to be considered when planning a preoperative educational program for patients undergoing total joint replacement surgery. This study's situation-specific measure of self-efficacy could be used in the clinical setting to identify patients with low levels of self-efficacy who may be less likely to perform preventive postoperative behaviors.