Review and synthesis of the experience of patients following total hip or knee arthroplasty in the era of rapidly decreasing hospital length of stay

Jpn J Nurs Sci. 2020 Oct;17(4):e12361. doi: 10.1111/jjns.12361. Epub 2020 Aug 24.

Abstract

Aim: The hospital length of stay for orthopedic surgery has been decreasing during the last couple of decades. Therefore, this study was performed to explore the postoperative experiences of adult/older patients (age ≥20 years) with osteoarthritis who underwent total hip or knee arthroplasty, focusing on the first 6 weeks following discharge.

Methods: A systematic literature search on qualitative studies was conducted using six databases, such as Medline, CINAHL and Mednar. Verbatim interview data and themes or subthemes related to the patients' experience after discharge were extracted. Content analysis was used to code interview data. Codes similar in meaning were grouped, and subcategories were formed. These subcategories were then grouped into categories.

Results: Sixteen qualitative studies with 253 participants were analyzed. In total, 136 codes were generated and formed 29 subcategories. Six categories were generated: (a) postoperative pain and medication; (b) difficulty in performing activities of daily living; (c) appreciation for support and difficulties associated with receiving support; (d) variability in recovery process and information-seeking; (e) lack of patient-centered care; and (f) transportation problems and social isolation.

Conclusion: Our review suggests that prospective patients and their caregivers need individually tailored presurgical education and advanced planning for postsurgical reduced mobility.

Keywords: patient education as topic; postoperative period; qualitative research; total hip replacement; total knee replacement.

Publication types

  • Systematic Review

MeSH terms

  • Activities of Daily Living
  • Adult
  • Arthroplasty, Replacement, Hip*
  • Arthroplasty, Replacement, Knee*
  • Hospitals
  • Humans
  • Length of Stay
  • Mobility Limitation
  • Patient Education as Topic*
  • Preoperative Period
  • Prospective Studies