Total Knee ArthroplastyNCT07335809
Impact of ABC-X Model Nursing on Psychological Resilience and Family Function in TKA Patients
An observational study of Total Knee Arthroplasty, run by The Fourth Affiliated Hospital of Zhejiang University School of Medicine.
Trial summary
The ABC-X model is a systematic intervention approach based on stress source analysis and adaptation theory. It emphasizes the dynamic interaction between stressors (A), coping resources (B), cognitive appraisal (C), and crisis outcomes (X). Read more about this study
- Who is it for?
- Ages 30 to 65 years
- Conditions the study is for
- Total Knee Arthroplasty
- What is being tested?
- Implement nursing interventions based on the ABC-X model
- How many people
- 117 participants
- Where
- No sites listed yet
- Study dates
- 20 Dec 2025to 30 Dec 2028
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: A total of 117 patients who underwent TKA for knee osteoarthritis from July 2025 to July 2026 were selected as the study subjects.
Who may be able to join
- Meet the diagnostic criteria for knee osteoarthritis as outlined in the Guidelines for Diagnosis and Treatment of Osteoarthritis (2018 Edition)[6], with confirmation by imaging examination;
- Age 30-65 years;
- Meet the surgical indications of our hospital and be a first-time candidate for unilateral TKA;
- Normal neurological and cognitive function, with stable vital signs;
- Family members have signed the informed consent form.
Who cannot join
- Presence of lower limb movement impairments;
- Accompanied by severe complications;
- Infectious diseases or severe immune system disorders;
- Other acute and critical illnesses;
- History or presence of mental dysfunction;
- Language or communication disorders.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Study on the Impact of Nursing Interventions Based on the ABC-X Model on Psychological Resilience and Family Functioning in Patients After Total Knee Arthroplasty
The ABC-X model is a systematic intervention approach based on stress source analysis and adaptation theory. It emphasizes the dynamic interaction between stressors (A), coping resources (B), cognitive appraisal (C), and crisis outcomes (X). By systematically assessing patients' psychosocial stress, integrating family and social support resources, and optimizing disease cognition, it helps patients and their families alleviate psychological pressure and cope with disease challenges. This study aims to explore the impact of nursing interventions based on the ABC-X model on coping styles and family functioning in patients after total knee arthroplasty.
Read the detailed description
Total Knee Arthroplasty (TKA) is primarily indicated for patients with knee joint diseases that are unresponsive to conservative treatment and significantly impair daily life and work, such as osteoarthritis, rheumatoid arthritis, traumatic arthritis, osteonecrosis, or other inflammatory joint conditions. It is one of the widely used and well-established surgical procedures in the field of orthopedics. This surgery can effectively alleviate pain, correct joint deformities, and restore joint function. However, TKA may still be associated with various postoperative complications. Coupled with the prolonged off-hospital rehabilitation period, patients often exhibit insufficient compliance and limited coping strategies, which can adversely affect their postoperative recovery outcomes. Current routine nursing care primarily focuses on consolidating surgical outcomes, preventing complications, and promoting functional recovery. While it helps improve patients' daily activity levels and facilitates postoperative rehabilitation, it lacks systematic intervention in addressing patients' psychological stress, family support, and the integration of social resources. Moreover, patients often experience varying degrees of impaired self-care ability in the short term after surgery, necessitating reliance on family members for daily assistance. Therefore, when patients transition from hospital to family and social life, providing them with a professional and multifaceted nursing model is crucial, as it directly influences the speed and quality of their recovery.
- Conditions
- Total Knee Arthroplasty
- Being tested
- Implement nursing interventions based on the ABC-X model
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Implement nursing interventions based on the ABC-X modelOther
Establish a Nursing Team Based on the ABC-X Model
Implement the Nursing Intervention Plan:
- A - Stressor Assessment, including physiological assessment, assessment of life challenges, and evaluation of the social support network.
- B - Coping Resources, involving organizing medical system resources, individual internal resources, and family and social resources.
- C - Cognitive Appraisal: Use open-ended questioning to help patients understand the normality of stress responses, reduce fear of negative emotions, and minimize self-blame.
- X - Crisis Outcome, assessing the patient's emotional state, behavioral responses, physiological reactions, and family functioning.
The intervention will be conducted over a period of 6 months.
What is being measured
The primary outcome is the main question the study is designed to answer.
Postoperative recovery effectiveness
Postoperative recovery effectiveness: Six months after surgery, the modified Macnab criteria are used for therapeutic evaluation: Excellent indicates complete symptom relief with return to normal daily life and work; Good indicates mild symptoms with slight limitations on daily activities, without adverse effects on daily life and work; Fair indicates significant symptom relief but with limitations on daily activities and adverse effects on daily life and work; Poor indicates no improvement or worsening of symptoms before and after treatment.
Measured: The intervention will be conducted over a period of 6 months.
Psychological resilience
Psychological resilience：Evaluated using the Resilience Scale (CD-RISC), which has a Cronbach's α coefficient of 0.875, including three dimensions: strength (10 items, 40 points), optimism (8 items, 32 points), and 韧性 (7 items, 28 points). Each item is scored from 0 to 4 points, with a total score of 100 points, with higher scores indicating better psychological resilience.
Measured: Intervention will take place within 6 months.
Self-care ability
The Self-Care Ability Scale (ESCA) was used for evaluation, with a Cronbach's α coefficient of 0.86~0.92. It consists of 4 dimensions and 43 items, with each item scored on a scale of 0 to 4 points. The total score ranges from 0 to 172, with higher scores indicating stronger self-care ability.
Measured: Intervention will take place within 6 months
Rehabilitation exercise adherence
The Functional Exercise Adherence Scale for Orthopedic Patients was used for assessment. This scale consists of 3 dimensions and 15 items, covering exercise adherence related to physical aspects, psychological aspects, and active learning. A 1-5 point Likert 5-point rating scale is used, with a total score of 75 points. Scores <20 points, 20-55 points, and ≥55 points respectively indicate low adherence, partial adherence, and high adherence.
Measured: Intervention will take place within 6 months
Family functions
The Family Function Assessment Scale (APGAR) was used for evaluation, with a Cronbach's α coefficient of 0.856. It consists of 5 items: cooperativeness, adaptability, emotional quality, maturity, and intimacy. Each item is scored out of 10, with higher scores indicating better family function.
Measured: Intervention will take place within 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jan 2026
- Study start20 Dec 2025 (estimated)
- Primary completion30 Dec 2028 (estimated)
- Study completion30 Dec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Total Knee ArthroplastyStudies of the same condition, open and under way.
- More trials run by The Fourth Affiliated Hospital of Zhejiang University School of MedicineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Prospective
- Enrolment
- 117 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07335809
- Sponsor's protocol ID
- KY-2025-219
- Status last verified
- Dec 2025
- First submitted
- 15 Dec 2025
- Last updated
- 13 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 13 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Study on the Impact of Nursing Interventions Based on the ABC-X Model on Psychological Resilience and Family Functioning in Patients After Total Knee Arthroplasty
- ClinicalTrials.gov ID
- NCT07335809
- Acronym / sponsor ID
- KY-2025-219
- Conditions
- Total Knee Arthroplasty
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 117 participants (estimated)
- Lead sponsor
- The Fourth Affiliated Hospital of Zhejiang University School of MedicineUniversity, hospital or other
- Study start
- 20 Dec 2025 (estimated)
- Primary completion
- 30 Dec 2028 (estimated)
- Study completion
- 30 Dec 2028 (estimated)
- First posted
- 13 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The ABC-X model is a systematic intervention approach based on stress source analysis and adaptation theory. It emphasizes the dynamic interaction between stressors (A), coping resources (B), cognitive appraisal (C), and crisis outcomes (X). By systematically assessing patients' psychosocial stress, integrating family and social support resources, and optimizing disease cognition, it helps patients and their families alleviate psychological pressure and cope with disease challenges. This study aims to explore the impact of nursing interventions based on the ABC-X model on coping styles and family functioning in patients after total knee arthroplasty.
Detailed description
Total Knee Arthroplasty (TKA) is primarily indicated for patients with knee joint diseases that are unresponsive to conservative treatment and significantly impair daily life and work, such as osteoarthritis, rheumatoid arthritis, traumatic arthritis, osteonecrosis, or other inflammatory joint conditions. It is one of the widely used and well-established surgical procedures in the field of orthopedics. This surgery can effectively alleviate pain, correct joint deformities, and restore joint function. However, TKA may still be associated with various postoperative complications. Coupled with the prolonged off-hospital rehabilitation period, patients often exhibit insufficient compliance and limited coping strategies, which can adversely affect their postoperative recovery outcomes. Current routine nursing care primarily focuses on consolidating surgical outcomes, preventing complications, and promoting functional recovery. While it helps improve patients' daily activity levels and facilitates postoperative rehabilitation, it lacks systematic intervention in addressing patients' psychological stress, family support, and the integration of social resources. Moreover, patients often experience varying degrees of impaired self-care ability in the short term after surgery, necessitating reliance on family members for daily assistance. Therefore, when patients transition from hospital to family and social life, providing them with a professional and multifaceted nursing model is crucial, as it directly influences the speed and quality of their recovery.
Study design
- Observational model
- Other
- Time perspective
- Prospective
Who may qualify
- Ages
- 30 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- A total of 117 patients who underwent TKA for knee osteoarthritis from July 2025 to July 2026 were selected as the study subjects.
Key inclusion criteria (5 listed)
- Meet the diagnostic criteria for knee osteoarthritis as outlined in the Guidelines for Diagnosis and Treatment of Osteoarthritis (2018 Edition)[6], with confirmation by imaging examination;
- Age 30-65 years;
- Meet the surgical indications of our hospital and be a first-time candidate for unilateral TKA;
- Normal neurological and cognitive function, with stable vital signs;
- Family members have signed the informed consent form.
Key exclusion criteria (6 listed)
- Presence of lower limb movement impairments;
- Accompanied by severe complications;
- Infectious diseases or severe immune system disorders;
- Other acute and critical illnesses;
- History or presence of mental dysfunction;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Implement nursing interventions based on the ABC-X modelEstablish a Nursing Team Based on the ABC-X Model Implement the Nursing Intervention Plan: 1. A - Stressor Assessment, including physiological assessment, assessment of life challenges, and evaluation of the social support network. 2. B - Coping Resources, involving organizing medical system resources, individual internal resources, and family and social resources. 3. C - Cognitive Appraisal: Use open-ended questioning to help patients understand the normality of stress responses, reduce fear of negative emotions, and minimize self-blame. 4. X - Crisis Outcome, assessing the patient's emotional state, behavioral responses, physiological reactions, and family functioning. The intervention will be conducted over a period of 6 months. | Other | – |
Primary outcome
Postoperative recovery effectiveness
Time frame: The intervention will be conducted over a period of 6 months.
Postoperative recovery effectiveness: Six months after surgery, the modified Macnab criteria are used for therapeutic evaluation: Excellent indicates complete symptom relief with return to normal daily life and work; Good indicates mild symptoms with slight limitations on daily activities, without adverse effects on daily life and work; Fair indicates significant symptom relief but with limitations on daily activities and adverse effects on daily life and work; Poor indicates no improvement or worsening of symptoms before and after treatment.
Psychological resilience
Time frame: Intervention will take place within 6 months.
Psychological resilience：Evaluated using the Resilience Scale (CD-RISC), which has a Cronbach's α coefficient of 0.875, including three dimensions: strength (10 items, 40 points), optimism (8 items, 32 points), and 韧性 (7 items, 28 points). Each item is scored from 0 to 4 points, with a total score of 100 points, with higher scores indicating better psychological resilience.
Self-care ability
Time frame: Intervention will take place within 6 months
The Self-Care Ability Scale (ESCA) was used for evaluation, with a Cronbach's α coefficient of 0.86~0.92. It consists of 4 dimensions and 43 items, with each item scored on a scale of 0 to 4 points. The total score ranges from 0 to 172, with higher scores indicating stronger self-care ability.
Rehabilitation exercise adherence
Time frame: Intervention will take place within 6 months
The Functional Exercise Adherence Scale for Orthopedic Patients was used for assessment. This scale consists of 3 dimensions and 15 items, covering exercise adherence related to physical aspects, psychological aspects, and active learning. A 1-5 point Likert 5-point rating scale is used, with a total score of 75 points. Scores <20 points, 20-55 points, and ≥55 points respectively indicate low adherence, partial adherence, and high adherence.
Family functions
Time frame: Intervention will take place within 6 months
The Family Function Assessment Scale (APGAR) was used for evaluation, with a Cronbach's α coefficient of 0.856. It consists of 5 items: cooperativeness, adaptability, emotional quality, maturity, and intimacy. Each item is scored out of 10, with higher scores indicating better family function.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jan 2026.
- Individual participant dataSharing planned: Undecided
Related trials for Total Knee Arthroplasty
RecruitingPhase 3
REGN7508 Versus Apixaban and Enoxaparin for Thromboprophylaxis After Total Knee Arthroplasty in Adults
Venous Thromboembolism (VTE)
Recruiting
SII Levels Following iPACK Block With Adductor Canal Block in Knee Arthroplasty
Knee Osteoarthritis
Enrolling by invitationObservational study
Persona SoluTion PPS Femur PMCF
Rhematoid Arthritis, Osteo Arthritis of the Knee
Recruiting
ACB and iPACK Blocks With Intravenous Dexamethasone and Perineural Dexmedetomidine in Total Knee Arthroplasty
Knee Osteoarthritis
RecruitingPhase 3
REGN7508 Versus Acetylsalicylic Acid (ASA) for Venous Thromboprophylaxis After Total Knee Arthroplasty in Adult Participants
Symptomatic Venous Thromboembolism (VTE)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
An observational study of Total Knee Arthroplasty, run by The Fourth Affiliated Hospital of Zhejiang University School of Medicine.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 13 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact wenying wu (18857176306, 3435395541@qq.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postoperative recovery effectiveness (time frame: The intervention will be conducted over a period of 6 months.). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2026.