Evidence map›Paper›PMID 42399862›Full record

SynthesisBMC musculoskeletal disorders2026

Non-pharmacological interventions to reduce postoperative anxiety in total hip arthroplasty: a systematic review.

Elisabet Ripoll-Romero, Zaida Agüera, Montserrat Puig-Llobet, Andrea Vigueras, Jordi Galimany-Masclans

Abstract readSystematic Review
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elisabet Ripoll-RomeroDepartment of Orthopedic Surgery, Hospital Clinic de Barcelona, Barcelona, 08036, Spain.
Zaida AgüeraDepartament d'Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Facultat d'Infermeria, Universitat de Barcelona, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain. zaguera@ub.edu.
Montserrat Puig-LlobetDepartament d'Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Facultat d'Infermeria, Universitat de Barcelona, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain. monpuigllob@ub.edu.
Andrea ViguerasDepartment of Orthopedic Surgery, Hospital Clinic de Barcelona, Barcelona, 08036, Spain.
Jordi Galimany-MasclansDepartament d'Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Facultat d'Infermeria, Universitat de Barcelona, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTotal hip arthroplasty is the surgical treatment of choice to improve the quality of life of patients with advanced osteoarthritis. This treatment aims to increase functional capacity and reduce pain. However, anxiety is one of the most frequently described uncomfortable experiences associated with this surgery. Although there has been extensive study of techniques to treat preoperative anxiety, little is known about interventions targeted at reducing postoperative anxiety associated with the fear and uncertainty of adjusting to life changes after surgery.

aimTo conduct a systematic review of the literature to identify the non-pharmacological interventions that have been performed to reduce postoperative anxiety in patients undergoing hip arthroplasty and their effectiveness.

methodsA bibliographic search was conducted in Pubmed, Scopus, and Web of Science until April 2026. Search was based on the following selection criteria: randomized clinical trials, quasi-experimental pre-post studies with or without control groups. Study selection and data analysis were conducted according to the predefined eligibility criteria and analytical approach, and the reporting was conducted according to the PRISMA 2020 guidelines. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and ROBINS-I for non-randomized studies.

resultsIncluded studies assessed technology-assisted interventions (immersive virtual reality, telemedicine, and video-based health education), nursing-led educational or behavioral programs (including self-efficacy-enhancing and continuous nursing care models), multimodal rehabilitation-based approaches, and complementary therapies such as aromatherapy. Overall, the most consistent reductions in anxiety were observed in studies evaluating immersive virtual reality and self-efficacy-enhancing interventions. Nursing-led and continuous care models also reported improvements, although findings were more variable. Educational and eHealth-based approaches showed benefits primarily in the short term. Telemedicine and aromatherapy demonstrated limited or inconsistent effects on anxiety. Substantial heterogeneity in interventions, outcome measures, and follow-up periods precluded quantitative synthesis; therefore, a structured narrative synthesis was performed.

conclusionMulticomponent nursing-led and technology-assisted interventions, particularly immersive virtual reality and self-efficacy-based programs, show the most consistent evidence for reducing postoperative anxiety following THA. Educational and eHealth-based interventions demonstrate short-term benefits, whereas telemedicine and complementary approaches such as aromatherapy show more limited or inconsistent effects. However, the overall evidence base remains heterogeneous and methodologically variable. Future research should prioritise adequately powered, multicentre trials with standardised outcome measures and longer follow-up periods.

Indexed as

AnxietyArthroplasty, Replacement, HipHumansOsteoarthritis, HipQuality of LifeHip arthroplastyNursing interventionOsteoarthrosisPostoperative anxietyRecovery

Identifiers

PMID42399862
PMCPMC13599267

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.