Patients’ experiences during the first 12 weeks after discharge in fast-track hip and knee arthroplasty – a qualitative study

• Published in: International journal of orthopaedic and trauma nursing Vol. 31; pp. 13 - 19
• Main Authors: Specht, Kirsten, Agerskov, Hanne, Kjaersgaard-Andersen, Per, Jester, Rebecca, Pedersen, Birthe D.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-11-2018
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - psychology; Arthroplasty, Replacement, Hip - rehabilitation; Arthroplasty, Replacement, Knee - psychology; Arthroplasty, Replacement, Knee - rehabilitation; Female; Humans; Male; Middle Aged; Pain Management - methods; Pain Management - psychology; Pain, Postoperative - drug therapy; Pain, Postoperative - psychology; Patient Discharge; Patient Satisfaction; Postoperative Care - methods; Postoperative Care - psychology; Qualitative Research; Surveys and Questionnaires; Time Factors
• ISSN: 1878-1241; 1878-1292
• DOI: 10.1016/j.ijotn.2018.08.002

Due to the shortened length of stay in fast-track total hip and knee arthroplasty, patients must at a very early stage following surgery take responsibility for their postoperative care and treatment. It is important to establish if this treatment modality of fast-track is not only cost-effective, but meets patients’ expectations and needs.
To explore the lived experience of patients in fast-track total hip and knee arthroplasty during the first 12 weeks after discharge.
A phenomenological-hermeneutic approach was used inspired by Ricoeur’s theory of narrative and interpretation. Data were collected through semi-structured interviews with 8 patients 2 and 12 weeks after discharge.
Through the structural analysis 3 themes emerged: 1) Dealing with transition between hospital and home, 2) Pain and self-management of medication, 3) Challenges in rehabilitation.
Patients appreciated only 1 or 2 days in hospital. However, they were not sufficiently involved in the discharge planning. There was a feeling of uncertainty and being left on their own after discharge, which could affect their pain management and recovery at home. There is a need to develop in partnership with each individual patient a post discharge plan of care and rehabilitation to meet their individual needs, preferences and mode of motivation.