Exploring patient acceptability of a short‐stay care pathway in hospital post arthroplasty: A theory‐informed qualitative study

McDonald, Cassie E; Paynter, Camille; Francis, Jill J; Rodda, Daevyd; Bajwa, Supreet; Jackson, Dwane; Story, David A

doi:10.1111/hex.13561

Cited by 9 publications

(33 citation statements)

References 33 publications

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“…The authors conducted a qualitative study exploring patients' retrospective acceptability of a complex intervention involving surgery together with a short hospital stay and home‐based follow‐up care. The Acceptability of Short‐Stay Post Arthroplasty (ASAP) Study ‐ Patient perspectives (ASAP Study; McDonald et al, 2022) was conducted from July to October 2021. Ethical approval for the ASAP Study was obtained from the University of Melbourne Office of Research Ethics and Integrity (Approval ID: 2021‐22186‐20081‐4).…”

Section: Methodsmentioning

confidence: 99%

“…Ethical approval for the ASAP Study was obtained from the University of Melbourne Office of Research Ethics and Integrity (Approval ID: 2021‐22186‐20081‐4). Full methods of the ASAP Study are described elsewhere (McDonald et al, 2022). In summary, the researchers approached the ASAP Study through an interpretivist paradigm, paying attention to people's perspectives in context (Ritchie et al, 2013).…”

Section: Methodsmentioning

confidence: 99%

“…In this manuscript we use methodology to simply mean the study of the research methods. We applied the TFA in a qualitative study using semi-structured interviews with patient participants to explore the acceptability of a complex surgical intervention (McDonald et al, 2022). Furthermore, we sought to explore whether the TFA is adequate (hereafter referred to as 'theoretical sufficiency') to describe the interview data from the surgical context.…”

Section: Backgrou N Dmentioning

confidence: 99%

“…2021-22186-20081-4). Full methods of the ASAP Study are described elsewhere (McDonald et al, 2022). In summary, the researchers approached the ASAP Study through an interpretivist paradigm, paying attention to people's perspectives in context (Ritchie et al, 2013).…”

Section: Study Design and Settingmentioning

confidence: 99%

“…In this paper, we provide a detailed description of the application of the TFA in a theory‐informed semi‐structured interview study that investigated acceptability of a surgical intervention and associated care pathway, specifically, a short stay in hospital following joint replacement surgery. The aim of the empirical study was to explore patients' retrospective acceptability of the complex intervention (results reported in McDonald et al, 2022). The aims of the current methods article were to: (1) report on the theoretical sufficiency of the TFA, that is, whether it requires expanding to comprehensively assess acceptability of interventions that include surgery; and (2) provide methodological guidance for applying the TFA in qualitative interview‐based studies.…”

Section: Introductionmentioning

confidence: 99%

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Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights

Paynter

McDonald

Story

et al. 2023

British J Health Psychol

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PurposeMethods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research.MethodAcceptability was assessed in a consecutive sample of 15 patients at least 3 months post‐joint replacement surgery via theory‐informed semi‐structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings.ResultsInterview data were substantially codable into the TFA constructs but required the addition of a construct, labelled ‘perceived safety and risk’, and relabelling and redefining an existing construct (new label: ‘opportunity costs and gains’). Methodological recommendations for theory‐informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis.ConclusionThe sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory‐informed interview studies.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Backgrou N Dmentioning

confidence: 99%

Section: Study Design and Settingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights

Paynter

McDonald

Story

et al. 2023

British J Health Psychol

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Barriers and enablers to the implementation and sustainability of short‐stay arthroplasty programs for elective primary total hip and knee replacement: A systematic review with qualitative evidence synthesis

Berkovic,

Vallance,

Harris

et al. 2024

Musculoskeletal Care

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IntroductionWe aimed to systematically review contemporary evidence on the barriers and enablers to implementing and sustaining short‐stay arthroplasty programs for elective primary total hip and knee replacement from the perspectives of patients, health professionals, carers, healthcare administrators, funders and policymakers and to map the findings to the Theoretical Domains Framework (TDF).MethodsMedline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and the Cochrane Central Register of Controlled Trials were searched (up to 19 August 2023). Primary qualitative or mixed‐methods studies reporting on perspectives relating to the review aims that utilised a short‐stay programme were eligible for inclusion. Study quality was assessed using the qualitative critical appraisal tool from the Joanna Briggs Institute. Data were analysed inductively. The final themes were mapped to the TDF. The confidence in the findings was assessed using GRADE CERQual.ResultsFifteen studies were included. Twelve barrier themes and twelve enabler themes were identified. Three themes were graded with high confidence, 10 were graded with moderate confidence, three were graded with low confidence, and eight were graded with very low confidence. The most pertinent domains that the themes were mapped to for patients were beliefs about capabilities, reinforcement, and the environmental context and resources. Health professionals identified knowledge, environmental context and resources as important domains. Two domains were identified for carers: (1) social/professional role and identity and (2) memory, attention, and decision processes.ConclusionWe identified key barrier and enabler themes linked to the TDF that can be used to guide implementation initiatives and promote the sustainability of short‐stay arthroplasty programs.

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Preoperative lifestyle modifications combined with a structured exercise protocol on patient outcomes following total knee replacement surgery: A systematic review

Kan,

Page,

Devine

et al. 2024

Musculoskeletal Care

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BackgroundMedical guidelines recommend structured prehabilitation protocols consisting of lifestyle modifications and exercise to enhance post‐operative outcomes for patients undergoing a total knee replacement (TKR). However, current research showing effectiveness is limited and has primarily focused on outcomes of exercise‐based prehabilitation.ObjectivesTo investigate whether a structured prehabilitation protocol consisting of exercise and lifestyle modifications improves physical function and patient‐reported outcomes following TKR surgery compared with usual care.DesignSystematic review.MethodsFive databases were searched to identify randomised controlled trials comparing structured prehabilitation programs consisting of lifestyle modifications and exercise, with usual care, for those undergoing a TKR. Methodological quality of included studies was assessed via the RoB 2.0 tool and results synthesis via a Grading of Recommendation Assessment, Development and Evaluation approach was performed to determine the certainty evidence for each outcome.Results/findingsFour studies were included in this review. Despite a positive trend supporting the inclusion of a structured prehabilitation protocol, additional improvements in post‐operative pain, physical function and self‐reported function were only seen in one study. Reductions in hospital length of stay were also seen in one study. No additional improvements in post‐operative quality of life following prehabilitation were reported.ConclusionLimited evidence supporting prehabilitation reported in our review is likely attributed to the intervention type, intensity, and delivery model of included studies. However, there remains to be strong evidence supporting the use of a structured prehabilitation protocol consisting of lifestyle modifications and exercise to improve post‐operative outcome.

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Exploring patient acceptability of a short‐stay care pathway in hospital post arthroplasty: A theory‐informed qualitative study

Cited by 9 publications

References 33 publications

Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights

Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights

Barriers and enablers to the implementation and sustainability of short‐stay arthroplasty programs for elective primary total hip and knee replacement: A systematic review with qualitative evidence synthesis

Preoperative lifestyle modifications combined with a structured exercise protocol on patient outcomes following total knee replacement surgery: A systematic review

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