The Effect of the 5T Teach-Back Method on Respiratory Exercise and Incentive Spirometer Training

Official title

The Effect of the 5T Teach-Back Method in Respiratory Exercise and Incentive Spirometer Training on Knowledge Level, Practical Skills, Respiratory Parameters, and Patient Satisfaction: A Randomized Controlled Study

Overview

Breathing problems after surgery are common and can lead to serious complications such as low oxygen levels, lung collapse, or pulmonary embolism. These problems increase patient risk and place an additional burden on the healthcare system. Breathing exercises and incentive spirometer use are important methods to prevent these complications. However, many patients have difficulty understanding and correctly performing these exercises when education is limited to standard verbal instructions. This randomized controlled study aims to evaluate whether the 5T Teach-Back education method improves patients' understanding, practical skills, respiratory outcomes, and satisfaction compared with standard verbal education. The study will be conducted in a university hospital and will include 76 adult patients undergoing abdominal surgery under general anesthesia. Participants will be randomly assigned to either an intervention group or a control group. Patients in the intervention group will receive preoperative breathing exercise and incentive spirometer training using the 5T Teach-Back method, which encourages patients to explain the information back in their own words and repeat the skills until they are correctly understood. Patients in the control group will receive routine verbal education provided by clinical nurses. Outcomes will be measured before surgery and again within 24-72 hours after surgery. These outcomes include patients' knowledge level, correct performance of breathing exercises and spirometer use, respiratory rate, oxygen saturation, lung function test results, and patient satisfaction with nursing care. The results of this study are expected to show whether the 5T Teach-Back method is more effective than standard education in improving postoperative respiratory care and patient satisfaction. The findings may help standardize patient education practices and support nurses in delivering more effective respiratory training before surgery.

Interventions

• Behavioral 5T Teach-Back-Based Respiratory Exercise and Incentive Spirometer Education
  This intervention involves preoperative respiratory exercise and incentive spirometer education delivered using the structured 5T Teach-Back method. Education is provided individually by a trained nurse and includes demonstration, patient return demonstration, and repeated instruction until correct understanding and performance are achieved. The five steps of the 5T Teach-Back approach (Triage, Tools, Take Responsibility, Tell Me, and Try Again) are systematically applied to ensure patient compr
• Behavioral Standard Verbal Respiratory Education
  This intervention consists of routine verbal education on respiratory exercises and incentive spirometer use provided by clinical nurses as part of standard preoperative care. Education is delivered according to usual clinical practice without a structured teaching framework, return demonstration, or formal assessment of patient understanding. No standardized duration, repetition, or feedback process is applied. This intervention reflects typical routine care and differs from structured educatio

Primary outcome measures

• Patient Knowledge and Correct Performance of Respiratory Exercises and Incentive Spirometer Use [Time frame: From baseline (preoperative period) to 24-72 hours postoperatively]

Secondary outcome measures (4)

• Pulmonary Function Test [Time frame: 24-72 hours postoperatively]
• Patient Satisfaction [Time frame: 24-72 hours postoperatively]
• Respiratory Parameter (SpO₂) [Time frame: From baseline (preoperative period) to 24-72 hours postoperatively]
• Respiratory Rate [Time frame: From baseline (preoperative period) to 24-72 hours postoperatively]

Eligibility criteria

Inclusion criteria

• Adults aged 18 years or older
• Scheduled for abdominal surgery under general anesthesia
• Postoperative use of respiratory exercises and incentive spirometry is recommended
• Expected postoperative hospital stay of more than 3 days
• Able to read and write and able to communicate effectively
• Conscious, cooperative, and oriented
• Willing to participate voluntarily and able to provide written informed consent

Exclusion criteria

• Severe neurological or cognitive impairment
• Unstable vital signs or hemodynamic instability
• Anticipated or required postoperative intensive care unit admission
• Severe pain that prevents participation in education or assessments
• Visual or communication impairments that limit participation in education

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Prevention

Study locations

Center list to be confirmed — check the primary protocol.

Publications

• Wang J, Hu H, Sun J, Zhang Q, Chen Z, Wang Q, Zhu M, Yao J, Yuan H, Zhang X. The effectiveness of health education based on the 5Ts for teach-back on oral nutritional supplements compliance of post-discharge patients after surgery for gastric cancer: a randomized controlled trial. Support Care Cancer. 2023 Feb 11;31(3):157. doi: 10.1007/s00520-023-07581-1. PMID 36773116
• Anderson KM, Leister S, De Rego R. The 5Ts for Teach Back: An Operational Definition for Teach-Back Training. Health Lit Res Pract. 2020 Apr 9;4(2):e94-e103. doi: 10.3928/24748307-20200318-01. PMID 32293689

Identifiers

NCT: NCT07350616 · 973-973-11

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗