1. A pilot study to develop a non- pharmacology nursing intervention, to reduce pain in patients receiving total knee arthroplasty Gloria Greβ Claudia Sousa Oliveira Catharina van Oostveen F oundation for H ealthcare I mprovement R esearch Tarja Poikkeus Connie Lethin Maren Falch Lindberg

2. The European Academy of Nursing Science 2 Evidence Base Systematic Review 58% of the patients has moderate to severe pain after surgery Delay rehabilitation, compliations Wylde et al.(2011) Ranawat, A. S., Ranawat, C. S. (2007) Question: What is the effect of a complex non-pharmacologal nursing intervention] I for pain management] O for [patients receiving total knee arthroplasty] P Preoperative information about pain Cold therapy Music therapy Fletcher et al 2008; Kwan et al 2011; Cepeda et al 2009

3. The European Academy of Nursing Science 3 Theory: Three Dimensions of Pain PAIN R. Melzack & K. Casey (1968) Sensory Emotional Cognitive

4. Patient experience Non-pharmalogical I. Predictive Factors The European Academy of Nursing Science 4 Methods PHASE I INTERVENTION Systematic Review Qualitative Study Sensory Emotional Cognitive 1.Before Surgery – Training 2.During Surgery – Music Therapy 3.After Surgery – Cold Therapy

5. The European Academy of Nursing Science 5 Feasibility/Piloting PHASE II 1.Focus group interview, nurses 2.Interview patients 3.Observe the intervention 4.Diary Outcomes 1.Pain intensity 2.Opioid consumption 3.Length of stay 4.Re-admission 5.Costs per patients Inclusion process Intervention 10 pp UC 10 pp R R

6. Economic evaluation The European Academy of Nursing Science 6 Estimated expencesEur Personell costs900 Material costs4100 Salary phd student, 1 year60000 Sum65000

7. A pilot study to develop a non- pharmacology nursing intervention, to reduce pain in patients receiving total knee arthroplasty Gloria Greβ Claudia Sousa Oliveira Catharina van Oostveen F oundation for H ealthcare I mprovement R esearch Tarja Poikkeus Connie Lethin Maren Falch Lindberg