5, Whal is the purpose of this research study!

 You .ce being asked if you are interested in participating in this study because you are
 scheduled for joint replacement surgery. This study is being done to sea if there is a
 relationship belween yoLir spiri ual beliefs and your health evaluation and your need for pain
 medicine, "Te pu-jpos of ih atludy is to measure the amount of pain inediehiiOn you use for
 the frsi three dayi after your surgery,


6. Whnt will be done If you take part In this research sludy?

 You will be asked to participate in this sludy after you have been scheduled wilh Dr. Gearen.
 Dr. Myers, or Dr, Vlasak for hip or knee replacement surgery. Through your participation in
 this study you will be asked to conrpile Iwo sure queslionnaires. These survey
 questionnaires will take approximately 20 minutes to comptele. You do not have o answer
 all of the questions if you do not want lo answer all. The purpose of this study is ln cmprincE
 relationships between spiritual beliefs, spiritual involvement, a personal health evaluation
 and the amount oflpaiin irdicalaion use after join replicirnini surgery. Your medical record
 will be examined fcr there days ailer surgery to determine the amount of pain you report after
 surgery and the amount ofpain medication you use. Oitlr inormiaiion etrnirncd from your
 niedical record will includuc iour age, sex, dl.gnosis. loCAlIon ol'joint replacement and
 anesthesia given to you during your surgery. The Principal Invesligalor will code all of your
 informnlion wiih confidential code numbers, All orfyour data will kept in a locked secure
 file.

 All of your care will be normal procedures that are part of the ircatment for all patients
 having tolal joint replacement surgery. ThLre Iill be no diTerences in your treatment white
 you are part of this study.


7. What nre she possible discomforts and risks.

 'Thee % il1 be no poNssibl nsks for yci as a pa ticiprnl in this study. You may experience
 discomfort in answering queinions regardriin, our spintiulal').

 Thrlouia1uii ihc sirdy. the researcher will nolify you of new information Ihait rmy become
 available that may affect your decision to remain in the study.

 If you wish to discuss the information above or any disconforts you may experience, you may
 ask questions now or call the Principal Investigalor or contact person listed on the front page of
 this form.


SaB What are the possible benefits to you?

 There are no benefils Io you as par of Lhis study.


259-2003 / Rv 06-144 / Page 2 of 7