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Van Overschelde P, Van Lysebettens W, Lebleu J, Pauwels A, Parratte S. Quick Transition to One Day Length of Stay after Hip and Knee Arthroplasty Using a Digital Follow-Up Tool during COVID-19: A Retrospective Comparative Study. Healthcare (Basel) 2023; 11:2516. [PMID: 37761713 PMCID: PMC10531213 DOI: 10.3390/healthcare11182516] [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: 07/21/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic highlighted the need for efficient use of hospital infrastructure. The hypothesis was that a rapid shift to outpatient surgery after hip or knee arthroplasty could be implemented without compromising quality of care. The aim of this study was to assess the safety, pain management and patient-reported outcomes before and after the implementation of an accelerated discharge program using a digital follow-up tool. A retrospective cohort design was used to compare 97 patients who received primary total hip or knee arthroplasty during the pandemic (early discharge) to comparable 194 pre-pandemic patients (normal discharge). Both cohorts had the same inclusion criteria and were closely monitored using the digital follow-up tool. The accelerated discharge program reduced length of stay from a median of 3 days (before the pandemic) to a median of 1 day (during the pandemic) (p < 0.001). The complication rate of 2% was the same for both groups (p > 0.05). Patient-reported outcomes for matched samples of hip (n = 100) and knee (n = 82) arthroplasty patients were similar before, at 6 weeks and 3 months after surgery for both groups (p > 0.05). There were no differences in pain and medication consumption for the first 6 weeks (p > 0.05). This study demonstrates that reducing length of stay from three to one night after total knee or hip arthroplasty, with the help of a digital follow-up tool, results in a stable rate of complications, readmission, and comparable clinical outcomes, while reducing the socio-economic burden on the health system.
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Affiliation(s)
| | | | | | | | - Sebastien Parratte
- International Knee and Joint Centre, Abu Dhabi 46705, United Arab Emirates;
- Locomotion Institute, Aix-Marseille University, 13009 Marseille, France
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Ruseckaite R, Mudunna C, Caruso M, Ahern S. Response rates in clinical quality registries and databases that collect patient reported outcome measures: a scoping review. Health Qual Life Outcomes 2023; 21:71. [PMID: 37434146 DOI: 10.1186/s12955-023-02155-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Patient Reported Outcome Measures (PROMs) are being increasingly introduced in clinical registries, providing a personal perspective on the expectations and impact of treatment. The aim of this study was to describe response rates (RR) to PROMs in clinical registries and databases and to examine the trends over time, and how they change with the registry type, region and disease or condition captured. METHODS We conducted a scoping literature review of MEDLINE and EMBASE databases, in addition to Google Scholar and grey literature. All English studies on clinical registries capturing PROMs at one or more time points were included. Follow up time points were defined as follows: baseline (if available), < 1 year, 1 to < 2 years, 2 to < 5 years, 5 to < 10 years and 10 + years. Registries were grouped according to regions of the world and health conditions. Subgroup analyses were conducted to identify trends in RRs over time. These included calculating average RRs, standard deviation and change in RRs according to total follow up time. RESULTS The search strategy yielded 1,767 publications. Combined with 20 reports and four websites, a total of 141 sources were used in the data extraction and analysis process. Following the data extraction, 121 registries capturing PROMs were identified. The overall average RR at baseline started at 71% and decreased to 56% at 10 + year at follow up. The highest average baseline RR of 99% was observed in Asian registries and in registries capturing data on chronic conditions (85%). Overall, the average RR declined as follow up time increased. CONCLUSION A large variation and downward trend in PROMs RRs was observed in most of the registries identified in our review. Formal recommendations are required for consistent collection, follow up and reporting of PROMs data in a registry setting to improve patient care and clinical practice. Further research studies are needed to determine acceptable RRs for PROMs captured in clinical registries.
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Affiliation(s)
- Rasa Ruseckaite
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
| | - Chethana Mudunna
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Marisa Caruso
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Susannah Ahern
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
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Beit Ner E, Nakamura N, Lattermann C, McNicholas MJ. Knee registries: state of the art. J ISAKOS 2022; 7:118-131. [PMID: 34407996 DOI: 10.1136/jisakos-2021-000625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/10/2021] [Indexed: 01/11/2023]
Abstract
Sports injuries, trauma and the globally ageing and obese population require increasing levels of knee surgery. Shared decision making has replaced the paternalistic approach to patient management. Evidence-based medicine underpins surgical treatment strategies, from consenting an individual patient to national healthcare system design. The evolution of successful knee-related registries starting from specific arthroplasty registries has given rise to ligament reconstruction, osteotomy and cartilage surgery registries developing as platforms for surgical outcome data collection. Stakeholders include surgeons and their patients, researchers, healthcare systems, as well as the funding insurers and governments. Lately, implant manufacturers have also been mandated to perform postmarket surveillance with some hoping to base that on registry data. Aiming to assess the current status of knee-related registries, we performed a comprehensive literature and web search, which yielded 23 arthroplasty, 8 ligament, 4 osteotomy and 3 articular cartilage registries. Registries were evaluated for their scope, measured variables, impact and limitations. Registries have many advantages as they aim to increase awareness of outcomes; identify trends in practice over time, early failing implants, outlier surgeon or institution performance; and assist postmarketing surveillance. International collaborations have highlighted variations in practice. The limitations of registries are discussed in detail. Inconsistencies are found in collected data and measured variables. Potential measurement and selection biases are outlined. Without mandated data collection and with apparent issues such as unverified patient reporting of complications, registries are not designed to replace adverse event recording in place of a proper safety and efficacy study, as demanded by regulators. Registry 'big data' can provide evidence of associations of problems. However, registries cannot provide evidence of causation. Hence, without careful consideration of the data and its limitations, registry data are at risk of incorrectly drawn conclusions and the potential of misuse of the results. That must be guarded against. Looking at the future, registry operators benefit from a collective experience of running registries as they mature, allowing for improvements across specialties. Large-scale registries are not only of merit, improving with stakeholder acceptance, but also are critical in furthering our understanding of our patients' outcomes. In doing so, they are a critical element for our future scientific discourse.
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Affiliation(s)
- Eran Beit Ner
- Department of Trauma and Orthopaedic Surgery, Manchester University NHS Foundation Trust, Manchester, UK; Department of Orthopedic Surgery, Yitzhak Shamir Medical Center (Assaf Harofeh), affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel, Zerifin, Israel
| | - Norimasa Nakamura
- Global Center of Medical Engineering and Informatics, Osaka University, Osaka, Japan; Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Christian Lattermann
- Department of Orthopaedic Surgery MassGeneralBrigham (MGB), Brigham and Women's Distinguished Chair in Orthopaedic Surgery Chief: Division of Sports Medicine Director: Cartilage Repair Center Brigham and Women's Hospital Harvard Medical School, Chestnut Hill, Massachusetts, USA
| | - Michael James McNicholas
- Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Division of Cell Matrix Biology and Regenerative Medicine, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Manchester, UK.
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Ellison JS, Lorenzo M, Beck H, Beck R, Chu DI, Forrest C, Huang J, Kratchman A, Kurth A, Kurth L, Kurtz M, Lendvay T, Sturm R, Tasian G. Comparative effectiveness of paediatric kidney stone surgery (the PKIDS trial): study protocol for a patient-centred pragmatic clinical trial. BMJ Open 2022; 12:e056789. [PMID: 35383073 PMCID: PMC8983998 DOI: 10.1136/bmjopen-2021-056789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION The strength of the evidence base for the comparative effectiveness of three common surgical modalities for paediatric nephrolithiasis (ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy) and its relevance to patients and caregivers are insufficient. We describe the methods and rationale for the Pediatric KIDney Stone (PKIDS) Care Improvement Network Trial with the aim to compare effectiveness of surgical modalities in paediatric nephrolithiasis based on stone clearance and lived patient experiences. This protocol serves as a patient-centred alternative to randomised controlled trials for interventions where clinical equipoise is lacking. METHODS AND ANALYSIS The PKIDS is a collaborative learning organisation composed of 26 hospitals that is conducting a prospective pragmatic clinical trial comparing the effectiveness of ureteroscopy, shockwave lithotripsy and percutaneous nephrolithotomy for youth aged 8-21 years with kidney and/or ureteral stones. Embedded within clinical care, the PKIDS trial will collect granular patient-level, surgeon-level and institution-level data, with a goal enrolment of 1290 participants over a 21-month period. The primary study outcome is stone clearance, defined as absence of a residual calculus of >4 mm on postoperative ultrasound. Secondary outcomes include patient-reported physical, emotional and social health outcomes (primarily using the Patient-Reported Outcome Measurement Information System), analgesic use and healthcare resource use. Timing and content of secondary outcomes assessments were set based on feedback from patient partners. Heterogeneity of treatment effect for stone clearance and patient-reported outcomes by participant and stone characteristics will be assessed. ETHICS AND DISSEMINATION This study is approved by the central institutional review board with reliance across participating sites. Participating stakeholders will review results and contribute to development dissemination at regional, national and international meetings. TRIAL REGISTRATION NUMBER NCT04285658; Pre-results.
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Affiliation(s)
| | - Matthew Lorenzo
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Hunter Beck
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ruth Beck
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David I Chu
- Division of Urology, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Christopher Forrest
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jing Huang
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, Philadelphia, Pennsylvania, USA
| | - Amy Kratchman
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Anna Kurth
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Laura Kurth
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael Kurtz
- Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Renae Sturm
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Gregory Tasian
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, Philadelphia, Pennsylvania, USA
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Biant LC, Conley CW, McNicholas MJ. The First Report of the International Cartilage Regeneration and Joint Preservation Society's Global Registry. Cartilage 2021; 13:74S-81S. [PMID: 32075414 PMCID: PMC8808863 DOI: 10.1177/1947603520907664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The International Cartilage Regeneration and Joint Preservation Society's (ICRS's) global registry, aims to be the best source of information for patients and an unbiased resource of evidence-based medicine for scientists and clinicians working to help those unfortunate enough to suffer the pain and disability associated with articular cartilage lesions. This article constitutes the scientific summary of the reports' main findings. DESIGN The article outlines the historical precedents in the development of orthopedic registries from the earliest tumor registries, then local arthroplasty databases that led ultimately to international collaborations between national arthroplasty and soft tissue registries. The ICRS global cartilage registry was designed from the outset as a GDPR (General Data Protection Regulation) compliant, multilingual, multinational cooperative system. It is a web-based user-friendly, live in 11 languages by end 2019, which can be accessed via https://cartilage.org/society/icrs-patient-registry/. Patients and clinicians enter data by smartphone, tablet, or computer on any knee cartilage regeneration and joint preservation treatment, including the use of focal arthroplasty. Knee Injury and Osteoarthritis Outcome Score and Kujala patient-reported outcome measures are collected preoperatively, 6 months, 12 months, and annually for ten years thereafter. EQ-5D data collection will allow cost-effectiveness analysis. Strengths, weaknesses, and future plans are discussed. RESULTS Since inception the registry has 264 users across 50 countries. Major findings are presented and discussed, while the entire first ICRS global registry report is available at https://cartilage.org/society/icrs-patient-registry/registry-annual-reports/. Conclusion. A measure of the maturity of any registry is the publication of its findings in the peer reviewed literature. With the publication of its first report, the ICRS global registry has achieved that milestone.
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Affiliation(s)
- Leela C. Biant
- Trauma and Orthopaedic Surgery,
University of Salford, Manchester, UK,Department of Trauma and Orthopaedic
Surgery, University of Manchester, Manchester University Hospitals NHS Foundation
Trust, Manchester, UK
| | - Caitlin W. Conley
- Orthopaedic Surgery & Sports
Medicine, University of Kentucky, Lexington, KY, USA,Caitlin W. Conley, Orthopaedic Surgery &
Sports Medicine, University of Kentucky, 740 South Limestone Street, Suite K401,
Lexington, KY 40506, USA.
| | - Michael J. McNicholas
- Trauma and Orthopaedic Surgery,
University Hospital Aintree Teaching Hospital Major Trauma Centre Foundation Trust,
Longmoor Lane, Liverpool, UK
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Calabro L, Clement ND, MacDonald D, Patton JT, Howie CR, Burnett R. Venous thromboembolism after total knee arthroplasty is associated with a worse functional outcome at one year. Bone Joint J 2021; 103-B:1254-1260. [PMID: 34192925 DOI: 10.1302/0301-620x.103b7.bjj-2019-0636.r7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The primary aim of this study was to assess whether non-fatal postoperative venous thromboembolism (VTE) within six months of surgery influences the knee-specific functional outcome (Oxford Knee Score (OKS)) one year after total knee arthroplasty (TKA). Secondary aims were to assess whether non-fatal postoperative VTE influences generic health and patient satisfaction at this time. METHODS A study of 2,393 TKAs was performed in 2,393 patients. Patient demographics, comorbidities, OKS, EuroQol five-dimension score (EQ-5D), and Forgotten Joint Score (FJS) were collected preoperatively and one year postoperatively. Overall patient satisfaction with their TKA was assessed at one year. Patients with VTE within six months of surgery were identified retrospectively and compared with those without. RESULTS A total of 37 patients (1.5%) suffered a VTE and were significantly more likely to have associated comorbidities of stroke (p = 0.026), vascular disease (p = 0.026), and kidney disease (p = 0.026), but less likely to have diabetes (p = 0.046). In an unadjusted analysis, patients suffering a VTE had a significantly worse postoperative OKS (difference in mean (DIM) 4.8 (95% confidence interval (CI) 1.6 to 8.0); p = 0.004) and EQ-5D (DIM 0.146 (95% CI 0.059 to 0.233); p = 0.001) compared with patients without a VTE. After adjusting for confounding variables VTE remained a significant independent predictor associated with a worse postoperative OKS (DIM -5.4 (95% CI -8.4 to -2.4); p < 0.001), and EQ-5D score (DIM-0.169 (95% CI -0.251 to -0.087); p < 0.001). VTE was not independently associated with overall satisfaction after TKA (odds ratio 0.89 (95% CI 0.35 to 2.07); p = 0.717). CONCLUSION Patients who had a VTE within six months of their TKA had clinically significantly worse knee-specific outcome (OKS) and general health (EQ-5D) scores one year postoperatively, but the overall satisfaction with their TKA was similar to those patients who did not have a VTE. Cite this article: Bone Joint J 2021;103-B(7):1254-1260.
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Affiliation(s)
- Lorenzo Calabro
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Nick D Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Deborah MacDonald
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.,Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, UK
| | - James T Patton
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Colin R Howie
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.,Department of Orthopaedic Surgery, University of Edinburgh, Edinburgh, UK
| | - Richard Burnett
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
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Ashdown T, Park C, Begum F, Panagiotidou A, Sugand K, El-Tawil S. Do Patients Accurately Represent Their Experiences After Hip and Knee Replacements? Cureus 2021; 13:e12745. [PMID: 33614344 PMCID: PMC7886602 DOI: 10.7759/cureus.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background To investigate discrepancies, if any, between the complications that patients report on the patient-reported outcome measures (PROMs) questionnaire and what is formally recorded in their medical records. Methodology A retrospective analysis of PROMs-reported complications was performed at a single elective center for all patients who had an elective primary total knee or hip replacement between April 2016 and March 2017. Corresponding patient medical records were then analyzed to correlate the PROMs with any documentation of postoperative complications, which similar to the PROMs data were categorized into wound complications, urinary complications, readmission, and further operative procedures. Results A set of 54 complete patient records were compared to the corresponding PROMs data. The combined overall positive predictive value was 0.47 while the overall negative predictive value was 0.91. Concordance between patients and the medical records was 70.4% for wound complication, 66.7% for urinary complications, 83.3% for readmission, and 96.3% for reoperation. Conclusion PROMs data are becoming increasingly important in auditing and planning healthcare provision. This study highlights a significant level of discrepancy between the PROMs-reported complication rates and those documented in the medical records. There is a visible disparity between patient perception and the medical definition of postoperative complications. Further patient education and empowerment are required in preparation for arthroplasty.
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Affiliation(s)
- Thomas Ashdown
- Trauma and Orthopaedics, Northwick Park Hospital, London, GBR
| | - Chang Park
- Trauma and Orthopaedics, Northwick Park Hospital, London, GBR
| | - Fahima Begum
- Trauma and Orthopaedics, Northwick Park Hospital, London, GBR
| | | | - Kapil Sugand
- Trauma and Orthopaedics, Northwick Park Hospital, London, GBR
| | - Sherif El-Tawil
- Trauma and Orthopaedics, Northwick Park Hospital, London, GBR
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Martin SJ, Scholes CJ, Genon MP. Letter to the Editor on "Mortality and Implant Survival With Simultaneous and Staged Bilateral Total Knee Arthroplasty Experience From the Australian Orthopedic Association National Joint Replacement Registry". J Arthroplasty 2019; 34:2192-2193. [PMID: 31204224 DOI: 10.1016/j.arth.2019.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/14/2019] [Indexed: 02/01/2023] Open
Affiliation(s)
- Sam J Martin
- Department of Orthopaedic Surgery, Grafton Base Hospital, Grafton, New South Wales, Australia
| | | | - Michel P Genon
- Department of Orthopaedic Surgery, Grafton Base Hospital, Grafton, New South Wales, Australia
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Chen J, Zhu X, Jiang J, Qi Y, Shi Y. Needs of Chinese patients undergoing home-based rehabilitation after hip replacement: A qualitative study. PLoS One 2019; 14:e0220304. [PMID: 31348814 PMCID: PMC6660078 DOI: 10.1371/journal.pone.0220304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background The needs of Chinese patients undergoing home-based rehabilitation after hip replacement surgery remain unclear. In this study, we qualitatively investigated the needs of Chinese patients undergoing home-based rehabilitation after hip replacement surgery. Methods A total of 21 participants undergoing home-based rehabilitation after hip replacement surgery were included in this study. Individual semi-structured interviews involving all participants were performed to determine the needs and experiences of this patient population during home-based rehabilitation. Data were subjected to qualitative content analysis. Results The patients had numerous needs during rehabilitation. Three substantive themes, namely, the need to obtain health-related knowledge, the need to obtain care and support, and the needs of those who cannot perform self-care, were identified from the qualitative data. The participants shared valuable insights into their needs during home-based rehabilitation after hip replacement and provided potential suggestions. Conclusions Patients undergoing home-based rehabilitation after hip replacement have several strong needs and lack proper guidance. The initial and continuous engagement of rehabilitation professionals and the establishment of related policies based on patient’s needs are potential approaches for improving the effectiveness of home-based rehabilitation after hip replacement.
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Affiliation(s)
- Jing Chen
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoping Zhu
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinxia Jiang
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yan Qi
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yan Shi
- Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- * E-mail:
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