Health care needs of patients during early recovery after total knee-replacement surgery.
ABSTRACT The aim of this study was to understand the health care needs and related factors for patients with knee osteoarthritis during the early recovery period after total knee-replacement surgery.
Knee-replacement surgery effectively relieves pain and improves mobility for patients with knee osteoarthritis. With shorter hospital stays, postoperative knee-replacement patients need guidance from medical personnel about self-care, but little is known about these patients' health care needs.
This descriptive, correlational study used a longitudinal design.
A convenience sample of 85 patients undergoing total knee-replacement surgery in northern Taiwan was interviewed before and 1-2 weeks after hospital discharge. Data were collected on participants' demographic characteristics, disease characteristics, symptom distress and health care needs.
Participants' health care needs diminished significantly after hospital discharge. Before hospital discharge, the most important need was medical personnel to help relieve postoperative pain, and health care needs were predicted by symptom distress and age. After hospital discharge, the most important need was medical personnel to help understand the conditions requiring a return visit to hospital, and health care needs were predicted by symptom distress, health care needs before discharge, age and gender.
The results of this study provide a comprehensive understanding of health care needs before and after discharge, as well as predictive factors for patients undergoing total knee-replacement surgery.
Given today's shorter hospital stays, clinicians need to prioritise health care needs indicated by predictive variables. This strategy would help optimise assessment and care management by focusing on patients' greater health care needs and by tailoring care information and skills to patients' individual needs.
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ABSTRACT: To quantify the increase in ambulation produced by total knee replacement for osteoarthritis (OA) of the knee and to compare this with questionnaire-derived data. We compared the measured ambulatory activity and self-reported Nottingham Health Profile (NHP) data of 19 subjects with OA of the knee before and after total knee replacement (TKR). Subjects were considerably restricted in their measured activity before operation compared with subjects with less severe disease. At 6 months the activity had increased by an average of 79% (P=0.02). The pain scale of the NHP had significantly improved at 3 months, as had the mobility scale. Between 3 and 6 months, however, at the same time the measured activity was increasing, self-reported mobility declined. Replacement of a knee for OA is an effective way of improving ambulation. At 6 months the average increase amounted to 79%. Self-reported mobility did not correlate with mobility measured objectively.Rheumatology 08/2002; 41(7):755-8. · 4.44 Impact Factor
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ABSTRACT: • The purpose of this study was to describe patients' learning needs after hip arthroplasty and compare them prior to and 2 weeks after hospital discharge.• Data were collected in two phases from 22 surgical wards in 17 hospitals in Finland using a Canadian Patient Learning Needs Scale (Galloway et al., 1996). The first questionnaire (n=212, 81%) was completed before hospital discharge and the second (n=144, 55%) was completed at home after hospital discharge.• Results indicated that patients' learning needs diminished significantly after hospital discharge. In both questionnaires patients felt that the most important information was about complications and symptoms. Information about medication was ranked the second most important.• Demographic variables such as age, gender, education and working life were clearly related to learning needs. Women over 60 years old, and less educated and retired respondents had many learning needs.Journal of Clinical Nursing 08/2002; 11(5):634 - 639. · 1.23 Impact Factor
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ABSTRACT: To provide a more detailed description from patients' perspectives than is yet available of recovery from hip and knee arthroplasty and to use this information to test 2 assumptions about recovery from these procedures: that recovery from knee arthroplasty, as assessed by patients, routinely reaches the level achieved by hip arthroplasty; and that fatigue is prolonged after major orthopedic surgery. A cohort study. University teaching hospitals. Consecutive patients undergoing hip (n = 107) or knee (n = 53) arthroplasty. Unilateral hip or knee arthroplasty. Standardized self-rated measurements of pain, function, quality of life, and well-being from preoperatively to 6 months follow-up. Pain and function improved significantly less after knee arthroplasty than after hip arthroplasty, but the 2 procedures led to similar improvements in life evaluation, mood, and subjective health. Fatigue was only transiently increased. The findings were inconsistent with both assumptions. Nevertheless, despite poorer recovery in pain and function, patients receiving knee arthroplasty felt that life had improved as much as did patients with hip arthroplasty. Detailed information about how major joint arthroplasty in routine practice affects patients' lives can be used to advise patients and clinicians and can invalidate influential, but inaccurate, assumptions.Archives of Physical Medicine and Rehabilitation 04/2001; 82(3):360-6. · 2.44 Impact Factor