Patient and Caregiver Perspectives on an eHealth Tool: A Qualitative Investigation of Preferred Formats, Features and Characteristics of a Presurgical eHealth Education Module

Abstract

Introduction: Total hip and total knee replacement (THR and TKR) are suggested for reducing joint pain resulting from hip and knee osteoarthritis (OA), especially when other interventions have not resulted in desired outcomes. Providing prehabilitation education can improve patients’ psychological and physical well-being before and after surgery. The use of electronic health (eHealth) tools can be considered an effective method to increase patients’ access to prehabilitation, particularly for those facing barriers to attending diagnosis-specific in-person education sessions. However, limited attention is paid to both caregiver and patient perspectives regarding the delivery formats, features, and characteristics of eHealth tools. Method: Patients with hip (n = 46) and knee OA (n = 14) and their family caregivers (n = 16) participated in in-person focus groups or phone interviews. Participants were shown a mock-up of an eHealth module, and asked to share their preferences regarding the formats, features, and characteristics of the eHealth prehabilitation tool. Data was transcribed verbatim and coded using primary thematic and secondary content analyses. Result: Analyses revealed 3 main themes: 1. “easier to understand” emphasizes patients’ preferences on delivery formats and features; 2. “what does that mean?” highlights requests for clear and simple information; and 3. “Preparation, right?” shows patients’ perspectives on the best time to have access to the eHealth tool. Discussion: Participants’ preferences for prehabilitation tools included offering eHealth tools in multiple mediums of delivery (eg, written materials, pictures, videos). Participants preferred simplified information that emphasized the key points and rationale for the knowledge. There were differences in preferred timeline for having access to prehabilitation education, such as some participants wanting to receive prehabilitation well in advance, while others stated just before surgery was adequate. Our findings provide novel and actionable information about patient and caregiver perspectives on features and characteristics of prehabilitation education for patients with hip and knee OA.

Effect of a patient education video and prehabilitation on the quality of preoperative person-centred coordinated care experience: protocol for a randomised controlled trial

“…With Hong Kong’s ageing population, the demand for prehabilitation before complex high risk surgical procedures is expected to increase. Our development of a prehabilitation video was based on our previous positive experience with a multifaceted preoperative patient education programme8 and recent findings from qualitative studies measuring patients’ and caregivers’ perspectives of important elements in prehabilitation 25 26. Videos taken in real environment with clear explanations about the prehabilitation and expected postoperative recovery processes were common priorities identified in both studies 25 26.…”

“…Our development of a prehabilitation video was based on our previous positive experience with a multifaceted preoperative patient education programme8 and recent findings from qualitative studies measuring patients’ and caregivers’ perspectives of important elements in prehabilitation 25 26. Videos taken in real environment with clear explanations about the prehabilitation and expected postoperative recovery processes were common priorities identified in both studies 25 26. Prehabilitation could improve patient satisfaction through enhanced and continuous engagement with and support from healthcare providers during the presurgical period 25.…”

Introducing Virtual Prehabilitation to a UK Elective Total Hip Replacement service to improve patient outcomes: An overview of the literature and proposed implementation plan

“…Reid et al, 26 provides qualitative data on patients and caregivers’ views of teleprehabilitation prior to elective THR or TKR surgery. 76 participants were recruited (46 with Hip OA, 14 with knee OA, and 16 caregivers) and data gathered via semi-structured interviews (SSIs) and focus groups.…”

“…It can be argued this supports the hypothesis that patient-clinician interaction is important in compliance. 20,26…”

A Qualitative Study on Prehabilitation before Total Hip and Knee Arthroplasties: Integration of Patients’ and Clinicians’ Perspectives

“…All participants were asked questions about the available prehab for patients undergoing THA and TKA, the gaps in the current prehab, the benefits of prehab, and whether prehab could be done online. Each interview (45-60 min) and focus group (90 min) consisted of two main parts: the first, being preferred content and the learning preferences of patients with hip or knee OA in respect to presurgical education, and the second, focusing around the patients' preferred format for the presurgical education (e.g., images, text, different types of videos, and different types of questions) and feedback on an eHealth tool used to deliver prehab (more details about the second part have been provided in [22]. The data presented in this study are only based on the first part of the focus groups and semi-structured interviews.…”