Purpose: Following total knee replacement (TKR), patients must prepare quickly for discharge to home via education and rehabilitation. Patient needs may not fully be met prior to discharge after TKR surgery. The purpose of this descriptive study using transcendental phenomenology methods was to understand patients’ experiences when preparing to return home after TKR surgery. Method: Data was collected using semi-structured interviews that occurred 1 to 2 days prior to discharge in patients’ hospital rooms. Four participants were interviewed prior to discharge and interviews were transcribed verbatim for data analysis. Data analysis and data collection were concurrent, permitting subsequent interviews to be altered as needed based on results from previous participants. Thematic analysis of the interview transcriptions was conducted to identify significant meaning statements through a process of horizonalization. Significant statements were organized into shared themes among participants. Results: Three themes emerged: being supported for discharge home; having confidence in self, family and health care staff; and persevering: overcoming obstacles. Participants overall felt prepared for their surgery and the post-operative phase. The following factors increased readiness for discharge: having prior positive experience with TKR through the experiences of others, attending pre-operative education, interacting with knowledgeable staff, and having the appropriate support at home. Some patients were unprepared for the amount of pain they experienced after surgery. Conclusions/Recommendations: Health care providers should educate patients about safety for the home environment, adaptive techniques for functional tasks, and when to resume normal activities at home. Other implications include encouraging patients to attend pre-operative education, addressing patients’ previous experiences with TKR, both positive and negative, as well as providing realistic information regarding pain after surgery.
The authors would like to thank Laura Barnhart, OTR/L, Sarah Clifton, MS, OTR/L, Jerri Crager, OTR/L, Gretchen Roentz, OTR/L, and Saint Joseph East Hospital for their support of this research. Note to editor: All individual therapists listed above as well as the VP of Patient Care/Chief Nursing Officer of Saint Joseph East Hospital provided permission to be listed in the Acknowledgements section of this article.
Causey-Upton R, Howell DM. Patient Experiences When Preparing for Discharge Home after Total Knee Replacement. The Internet Journal of Allied Health Sciences and Practice. 2017 Jan 11;15(1), Article 5.