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Shetty S, Samuel AJ. Patients' Experiences, Satisfaction and Quality of Life With Physiotherapy Follow-Up After Total Knee Arthroplasty: A Phenomenological Qualitative Study Protocol. Musculoskeletal Care 2024; 22:e1948. [PMID: 39327645 DOI: 10.1002/msc.1948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 09/07/2024] [Accepted: 09/09/2024] [Indexed: 09/28/2024]
Abstract
INTRODUCTION Available quantitative studies indicate that patients who have undergone Total Knee Arthroplasty (TKA) experience dissatisfaction. There is a lack of comprehensive information on the experiences, satisfaction, and quality of life of patients after TKA. Hence, there is a need to explore the patients' perspective about the satisfaction and experiences undergoing rehabilitation and to explore the factors influencing quality of life with physiotherapy after 1st and 3rd months of TKA. METHODS 35 patients with post TKA, aged from 45 years, will participate in semi-structured face-to-face or telephone interviews. The participants will be recruited using criterion-based purposive sampling. The interviews will be audio-recorded and transcribed. NVivo 14V software and Braun and Clarke thematic analysis will be used. Credibility, transferability, dependability, and confirmability will be ensured. RESULTS The transcribed verbatim transcript will be analysed to generate sub-themes and themes using thematic analysis. Irrespective of the responses received from male or female patients' data would be analysed using inductive qualitative analysis to explore their perspectives. CONCLUSION This study is the first qualitative study from lower- and middle-income country that aims to investigate the satisfaction and experiences of patients after undergoing TKA rehabilitation. The efficacy of the data and subsequent suggestions would rely on the insights generated from the qualitative study, which would support the rehabilitation of patients in their later years.
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Affiliation(s)
- Saloni Shetty
- Yenepoya Physiotherapy College, Yenepoya (Deemed-to-be University), Mangalore, India
| | - Asir John Samuel
- Yenepoya Physiotherapy College, Yenepoya (Deemed-to-be University), Mangalore, India
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Kluit L, van Bennekom CAM, Beumer A, Sluman MA, de Boer AGEM, de Wind A. Clinical Work-Integrating Care in Current Practice: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:481-521. [PMID: 37966538 PMCID: PMC11364593 DOI: 10.1007/s10926-023-10143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Clinical work-integrating care (CWIC) refers to paying attention to work participation in a clinical setting. Working patients may benefit from CWIC. The purpose of this study is to explore the extent and nature to which medical specialists provide CWIC and what policies and guidelines oblige or recommend specialists to do. METHODS A scoping review was conducted. The databases MEDLINE, EMBASE, Psychinfo, CINAHL, and Web of Science were searched for studies on the extent and nature of CWIC and supplemented by gray literature on policies and guidelines. Six main categories were defined a priori. Applying a meta-aggregative approach, subcategories were subsequently defined using qualitative data. Next, quantitative findings were integrated into these subcategories. A separate narrative of policies and guidelines using the same main categories was constructed. RESULTS In total, 70 studies and 55 gray literature documents were included. The main findings per category were as follows: (1) collecting data on the occupation of patients varied widely; (2) most specialists did not routinely discuss work, but recent studies showed an increasing tendency to do so, which corresponds to recent policies and guidelines; (3) work-related advice ranged from general advice to patient-physician collaboration about work-related decisions; (4) CWIC was driven by legislation in many countries; (5) specialists sometimes collaborated in multidisciplinary teams to provide CWIC; and (6) medical guidelines regarding CWIC were generally not available. CONCLUSION Medical specialists provide a wide variety of CWIC ranging from assessing a patient's occupation to extensive collaboration with patients and other professionals to support work participation. Lack of medical guidelines could explain the variety of these practices.
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Affiliation(s)
- Lana Kluit
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands.
| | - Coen A M van Bennekom
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Research and Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
| | - Annechien Beumer
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Upper Limb Unit Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Maayke A Sluman
- Department of Cardiology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
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Zhang W, Ji H, Wang N, Sun K, Xu Z, Li J, Liu C, Sun Q, Wang C, Zhao F. The Needs and Experiences of Patients Returning to Work After Total Knee Arthroplasty and Total Hip Arthroplasty: A Systematic Review and Meta-Synthesis. Phys Ther 2024; 104:pzae024. [PMID: 38401168 DOI: 10.1093/ptj/pzae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/11/2023] [Accepted: 12/20/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE The objective of this study was to conduct a systematic and comprehensive review of qualitative research to examine the physical and psychological needs, as well as work experiences, of patients undergoing total knee replacement and total hip replacement surgeries during their process of returning to work. METHODS A systematic review and meta-synthesis of qualitative literature was conducted. A systematic search was conducted across 8 databases to identify qualitative or mixed-methods research on the needs and experiences of individuals with total knee replacement and total hip replacement who have returned to work. The search period extended from the inception of each database to March 2023. Two researchers independently utilized a predetermined search strategy to retrieve relevant English-language studies published in any year. The included studies were assessed for quality using the Critical Appraisal Skills Program appraisal tool. Findings from the studies were then summarized and integrated using the pooled integration method. RESULTS There were 10 studies in total. Three key themes were identified from the original research: needs during the return to work process and rehabilitation training, faith and support to return to work, and constraints and challenges at work. CONCLUSION Health care professionals and employers should conscientiously consider the physical and psychological requirements of patients who have undergone total knee replacement and total hip replacement when they are resuming work, taking into account the specific constraints and challenges that may arise in the workplace. To ensure a seamless transition back to work, it is essential to develop tailored occupational interventions, implement comprehensive return to work programs, and offer patients sufficient understanding and support. IMPACT The findings of this study offer valuable insights into the physical and psychological needs, as well as the work experiences, of patients who have undergone total knee replacement and total hip replacement during their reintegration into the workforce. These findings have the potential to assist health care professionals and employers in providing enhanced support to facilitate successful return-to-work outcomes for patients.
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Affiliation(s)
- Wenzhong Zhang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Hong Ji
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Ning Wang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Kangming Sun
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Zhenzhen Xu
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Jing Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Cuihong Liu
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- Quality Control Department, Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Qingxiang Sun
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Chunlei Wang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Fengyi Zhao
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Kluit L, de Wind A, Oosting IJ, van Velzen JM, Beumer A, Sluman MA, van Bennekom CAM, de Boer AGEM. Current practices, needs, and expectations of discussing work with a medical specialist from a patient's perspective: a qualitative study. Disabil Rehabil 2024; 46:115-128. [PMID: 36564948 DOI: 10.1080/09638288.2022.2157500] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 12/06/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE Attention to paid work in clinical health care-clinical work-integrating care (CWIC)-might be beneficial for patients of working age. However, the perceptions and expectations of patients about CWIC are unknown. The aim of this study was to develop an understanding of current practices, needs, and expectations among patients for discussing work with a medical specialist. MATERIALS AND METHODS A qualitative study was undertaken involving patients with diverse medical conditions (n = 33). Eight online synchronous focus groups were held. A thematic analysis was then performed. RESULTS Three themes emerged from the data: (1) the process of becoming a patient while wanting to work again, (2) different needs for different patients, (3) patients' expectations of CWIC. We identified three different overarching categories of work-concerns: (a) the impact of work on disease, (b) the impact of disease or treatment on work ability, and (c) concerns when work ability remained decreased. For each category of concerns, patients expected medical specialists to perform differing roles. CONCLUSIONS Patients indicated that they need support for work-related concerns from their medical specialists and/or other professionals. Currently, not all work concerns received the requested attention, leaving a portion of the patients with unmet needs regarding CWIC.
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Affiliation(s)
- Lana Kluit
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ilse J Oosting
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Judith M van Velzen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Heliomare Rehabilitation Center, Research and Development, The Netherlands
| | - Annechien Beumer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Upper Limb Unit Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Maayke A Sluman
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Cardiology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | - Coen A M van Bennekom
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Heliomare Rehabilitation Center, Research and Development, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Schroeder HS, Israeli A, Liebergall M(I, Or O, Abu Ahmed W, Paltiel O, Justo D, Zimlichman E. Perception of Goals and Expected Outcomes in Older Hip Fracture Patients and Their Medical Staff: A Cross Sectional Study. Geriatr Orthop Surg Rehabil 2023; 14:21514593231202735. [PMID: 37744458 PMCID: PMC10517609 DOI: 10.1177/21514593231202735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Background Goal-oriented patientcare is a key element in qualityhealthcare. Medical-caregiver's (MC) are expected to generate a shared decision-making process with patients regarding goals and expected health-outcomes. Hip-fracture patients (HFP) are usually older-adults with multiple health-conditions, necessitating that agreed-upon goals regarding the rehabilitation process, take these conditions into consideration. This topic has yet to be investigated by pairing and comparing the perception of expected outcomes and therapeutic goals of multidisciplinary MCs and their HF patient's. Our aim was to assess in a quantitative method whether HFPs and their multidisciplinary MCs agree upon target health-outcomes and their most important goals as they are reflected in the SF12 questionnaire. Methods This was a cross-sectional, multi-center, study of HFPs and their MCs. Patients and MCs were asked to rate their top three most important goals for rehabilitation from the SF12 eight subscales: physical functioning, physical role limitation, bodily pain, general health, vitality, social functioning, emotional role limitation and mental health, and indicate their expected outcome. Descriptive statistics and mixed effect logistic-regression were used to compare concordance of the ratings. Agreement between patients and MCs was assessed using interclass coefficients (ICCs). Results A total of 378 ratings were collected from 52 patients, 12 nurses, 12 physicians and 6 paramedical personnel. Each patient had between 3 and 9 raters. Patients considered physical functioning and physical role limitation more important than did MCs. Physicians and nurses emphasized the importance of bodily pain while patients referred to it as relatively less significant. The total ICC was low (2%) indicating poor agreement between MCs and patients. With the exception of physical-functioning, MCs predicted a less optimistic outcome in all of the SF12's subscales in comparison to HFPs. Conclusion Effective intervention in HFPs requires constructive communication between MCs and patients. The study suggests that caregivers have an insufficient understanding of the expectations of HFPs. More effective communication channels are required in order to better understand HFPs' needs and expectations.
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Affiliation(s)
- Hanna S. Schroeder
- Department of Nursing at the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Braun School of Public Health, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Avi Israeli
- Dr. Julien Rozan Professor of Healthcare, Hebrew University – Hadassah Medical School, Jerusalem, Israel
- Hadassah University Medical Center, Jerusalem, Israel
- Israel Ministry of Health, Jerusalem, Israel
| | - Meir (Iri) Liebergall
- Orthopedic Department of Surgery, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Omer Or
- Orthopedic Department of Surgery, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Wiessam Abu Ahmed
- Braun School of Public Health, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ora Paltiel
- Braun School of Public Health, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dan Justo
- Geriatrics Division, Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eyal Zimlichman
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Central Management, Sheba Medical Center, Ramat-Gan, Israel
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Zaballa E, Dennison E, Walker-Bone K. Function and employment after total hip replacement in older adults: A narrative review. Maturitas 2023; 167:8-16. [PMID: 36302339 DOI: 10.1016/j.maturitas.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/12/2022] [Accepted: 09/04/2022] [Indexed: 10/14/2022]
Abstract
The burden of osteoarthritis (OA) has increased steadily due to an aging population, increasing life expectancy, obesity and lifestyle factors. Total hip replacement has become one of the most prevalent and successful operations globally and it is projected that demand will continue to grow as the incidence of OA continues to increase. Patients undergoing the operation expect much-improved function and pain relief but also increasingly need to return to work postoperatively, especially given the growing demand for the procedure and the encouragement of older people to continue working by most governments in the developed world. This review provides an overview of function and employment outcomes after hip arthroplasty. Despite the generally good success rate, some patients do not attain good functional outcomes and it is important that we develop ways to identify these patients preoperatively. We describe the effect of demographic, clinical and other factors on functional outcomes, as well as trajectories of physical function and pain recovery beyond the first few weeks after total hip replacement. Regarding employment outcomes, many people in work preoperatively are likely to resume to work after recovery; however, patients feel that they lack guidance from clinicians about returning to work postoperatively. Our review encompasses factors associated with return to work, timing of return to work, and potential temporary or permanent limitations that people might experience at work depending on type of employment.
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Affiliation(s)
- Elena Zaballa
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK; Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Australia.
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Furlan AD, Harbin S, Vieira FF, Irvin E, Severin CN, Nowrouzi-Kia B, Tiong M, Adisesh A. Primary Care Physicians' Learning Needs in Returning Ill or Injured Workers to Work. A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:591-619. [PMID: 35511378 DOI: 10.1007/s10926-022-10043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
Primary care physicians are uniquely positioned to assist ill and injured workers to stay-at-work or to return-to-work. Purpose The purpose of this scoping review is to identify primary care physicians' learning needs in returning ill or injured workers to work and to identify gaps to guide future research. Methods We used established methodologies developed by Arksey and O'Malley, Cochrane and adapted by the Systematic Review Program at the Institute for Work & Health. We used Distiller SR©, an online systematic review software to screen for relevance and perform data extraction. We followed the PRISMA for Scoping Reviews checklist for reporting. Results We screened 2106 titles and abstracts, 375 full-text papers for relevance and included 44 studies for qualitative synthesis. The first learning need was related to administrative tasks. These included (1) appropriate record-keeping, (2) time management to review occupational information, (3) communication skills to provide clear, sufficient and relevant factual information, (4) coordination of services between different stakeholders, and (5) collaboration within teams and between different professions. The second learning need was related to attitudes and beliefs and included intrinsic biases, self-confidence, role clarity and culture of blaming the patient. The third learning need was related to specific knowledge and included work capacity assessments and needs for sick leave, environmental exposures, disclosure of information, prognosis of certain conditions and care to certain groups such as adolescents and pregnant workers. The fourth learning need was related to awareness of services and tools. Conclusions There are many opportunities to improve medical education for physicians in training or in continuing medical education to improve care for workers with an illness or injury that affect their work.
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Affiliation(s)
- Andrea D Furlan
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada.
- KITE, University Health Network, Toronto, ON, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Shireen Harbin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Fabricio F Vieira
- Faculty of Medicine, State University of Maringa, Avenida Colombo, 5790, CEP 87020-900, Maringa, PR, Brazil
| | - Emma Irvin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Colette N Severin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Margaret Tiong
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Anil Adisesh
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Occupational Medicine, St Michael's Hospital, Toronto, ON, Canada
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Zaballa E, Harris EC, Cooper C, Linaker CH, Walker-Bone K. Risk of revision arthroplasty surgery after exposure to physically demanding occupational or leisure activities: A systematic review. PLoS One 2022; 17:e0264487. [PMID: 35226696 PMCID: PMC8884506 DOI: 10.1371/journal.pone.0264487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/12/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Lower limb arthroplasty is successful at relieving symptoms associated with joint failure. However, physically-demanding activities can cause primary osteoarthritis and accordingly such exposure post-operatively might increase the risk of prosthetic failure. Therefore, we systematically reviewed the literature to investigate whether there was any evidence of increased risk of revision arthroplasty after exposure to intensive, physically-demanding activities at work or during leisure-time. METHODS We searched Medline, Embase and Scopus databases (1985-July 2021) for original studies including primary lower limb arthroplasty recipients that gathered information on physically-demanding occupational and/or leisure activities and rates of revision arthroplasty. Methodological assessment was performed independently by two assessors using SIGN, AQUILA and STROBE. The protocol was registered in PROSPERO [CRD42017067728]. RESULTS Thirteen eligible studies were identified: 9 (4,432 participants) after hip arthroplasty and 4 (7,137participants) after knee arthroplasty. Narrative synthesis was performed due to considerable heterogeneity in quantifying exposures. We found limited evidence that post-operative activities (work or leisure) did not increase the risk of knee revision and could even be protective. We found insufficient high-quality evidence to indicate that exposure to physically-demanding occupations increased the risk of hip revision although "heavy work", agricultural work and, in women, health services work, may be implicated. We found conflicting evidence about risk of revision hip arthroplasty associated with either leisure-time or total physical activities (occupational or leisure-time). CONCLUSION There is currently a limited evidence base to address this important question. There is weak evidence that the risk of revision hip arthroplasty may be increased by exposure to physically-demanding occupational activities but insufficient evidence about the impact on knee revision and about exposure to leisure-time activities after both procedures. More evidence is urgently needed to advise lower limb arthroplasty recipients, particularly people expecting to return to jobs in some sectors (e.g., construction, agriculture, military).
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Affiliation(s)
- Elena Zaballa
- Medical Research Council Life Course Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - E. Clare Harris
- Medical Research Council Life Course Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Cyrus Cooper
- Medical Research Council Life Course Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Catherine H. Linaker
- Medical Research Council Life Course Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Karen Walker-Bone
- Medical Research Council Life Course Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Medical Research Council Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
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Coole C, Baker P, McDaid C, Drummond A. Using intervention mapping to develop an occupational advice intervention to aid return to work following hip and knee replacement in the United Kingdom. BMC Health Serv Res 2020; 20:523. [PMID: 32517684 PMCID: PMC7285551 DOI: 10.1186/s12913-020-05375-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 05/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background There are increasing numbers of total hip replacements (THR) and total knee replacements (TKR) being performed in patients of working age. Providing patients undergoing TKR and THR with return to work advice might facilitate return to work. The aim of this paper is to report on the process used to systematically develop an occupational advice intervention to be delivered in hospital for those undergoing arthroplasty. Methods The six-step Intervention Mapping (IM) approach to development, implementation and evaluation of a theory and evidence-based interventions was followed. This paper reports on the development of the intervention covered by steps 1 to 4 of the IM process. Steps 1–3 gathered data on current practice and barriers to change using a mixed methods approach (cohort study of patients undergoing THR or TKR, stakeholder interviews, survey of practice, evidence synthesis) and provided a theoretical framework for intervention development. Step 4 used information from steps 1–3 in combination with a Delphi consensus process to develop the intervention and the associated tools and materials to facilitate its delivery. Results The final intervention identified included a number of core principles including: early patient identification; delivery of key information to patients and their employers; assessment and support by a member of the orthopaedic team; procedures for escalation based on patient need; mechanisms to support communication; and training and support for the clinical teams delivering care. A total of 13 patient and 20 staff performance objectives as delivery requirements, were supported by a range of tools, roles and training resources. The intervention addressed outcomes based at the individual and interpersonal levels of the ecological model. Conclusions Following the IM approach resulted in a structured and justified occupational intervention for delivery in secondary care for patients undergoing total hip and knee replacement. The feasibility of the intervention will subsequently be tested alongside further investigation to establish its effectiveness and cost-effectiveness.
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Affiliation(s)
- Carol Coole
- School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, England.,Medical School, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, England
| | - Paul Baker
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, TS4 3BW, England.
| | - Catriona McDaid
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington York, YO10 5DD, England
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, England.,Medical School, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, England
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