Striving for a silent knee: a qualitative study of patients’ experiences with knee replacement surgery and their perceptions of fulfilled expectations

Nyvang, Josefina Skogö; Hedström, Margareta; Iversen, Maura D.; Gleissman, Sissel Andreassen

doi:10.1080/17482631.2019.1620551

Cited by 9 publications

(23 citation statements)

References 19 publications

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“…This is particularly problematic as patients have identified lack of information regarding their course of recovery as a source of anxiety and potential barrier to the decision to undertake surgery [91,92]. Some patients recovering from TKA have also reported the information they receive about post-operative recovery is either insufficient or incongruent with their actual experience [93].…”

Section: Instrumented Insoles: Use Of Real-time Feedback To Improve Patient Outcomesmentioning

confidence: 99%

How New Technology Is Improving Physical Therapy

Owens¹,

Rauzi

Kittelson

et al. 2020

Curr Rev Musculoskelet Med

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Purpose of Review As rehabilitation patient volume across the age spectrum increases and reimbursement rates decrease, clinicians are forced to produce favorable outcomes with limited resources and time. The purpose of this review is to highlight new technologies being utilized to improve standardization and outcomes for patients rehabilitating orthopedic injuries ranging from sports medicine to trauma to joint arthroplasty. Recent Findings A proliferation of new technologies in rehabilitation has recently occurred with the hope of improved outcomes, better patient compliance and safety, and return to athletic performance. These include technologies applied directly to the patient such as exoskeletons and instrumented insoles to extrinsic applications such as biofeedback and personalized reference charts. Well-structured randomized trials are ongoing centered around the efficacy and safety of these new technologies to help guide clinical necessity and appropriate application. Summary We present a range of new technologies that may assist a diverse population of orthopedic conditions. Many of these interventions are already supported by level 1 evidence and appear safe and feasible for most clinical settings.

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Section: Instrumented Insoles: Use Of Real-time Feedback To Improve Patient Outcomesmentioning

confidence: 99%

How New Technology Is Improving Physical Therapy

Owens¹,

Rauzi

Kittelson

et al. 2020

Curr Rev Musculoskelet Med

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“…This study is the first empirical qualitative study that we know of to focus on knee replacement through an embodiment framework. Previous literature has focused on the disruption between the body and self after surgery (14,22,24), which contrasts with our work that focuses on incorporation of the prosthesis. We also identified new aspects of sensation (squeezing) that need to be understood more fully to provide better knowledge of embodiment issues after knee replacement.…”

Section: Discussionmentioning

confidence: 97%

“…A limitation of the study is that we did not collect information on reasons for nonparticipation, but the diverse characteristics of the sample and achievement of data saturation (28) means that we are confident that the findings are transferable to other people who received knee replacement in the UK. We also recognize that health systems vary between contexts and countries, but a study in Sweden also found that some patients lacked confidence in their replaced knee because of a lack of embodied connection (24). Another possible limitation is the risk that participants may give socially desirable accounts rather than their real perspectives (44).…”

Section: Discussionmentioning

confidence: 99%

“…How one comes to talk about the body as other is important to how one engages with rehabilitation. In chronic pain, for example, patients can come to discuss a joint, limb, or whole body as objectively other to the self, which is a risk for neglect, rehabilitation failure, and amputation (12,(22)(23)(24). Incorporation refers to the process of integrating something into one's body, either an object (e.g., a prosthesis) or a habit or skill (e.g., walking) (19).…”

Section: Introductionmentioning

confidence: 99%

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“It's Not My Knee”: Understanding Ongoing Pain and Discomfort After Total Knee Replacement Through Re‐Embodiment

Moore

Eccleston

Gooberman-Hill

2022

Arthritis Care & Research

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Objective. Up to 20% of people who undergo total knee replacement surgery have ongoing pain and discomfort. The aim of this study was to understand what role the concepts of embodiment (of both having a body and experiencing the world through one's body) and incorporation (integrating something into one's body) might have in understanding experiences of pain and discomfort after total knee replacement.Methods. We conducted semistructured interviews with 34 people who had received total knee replacement at either of 2 National Health Service hospitals in the UK, and who had chronic postsurgical pain (n = 34, ages 55-93 years). Data were audiorecorded, transcribed, and analyzed thematically.Results. Two main themes were identified: 1) when describing chronic postsurgical pain, some participants also described sensations of discomfort, including heaviness, numbness, pressure, and tightness associated with the prosthesis; 2) participants reported a lack of felt connection with and agency over their replaced knee, often describing it as alien or other, and lacked confidence in the knee.Conclusion. Participants' experiences indicate that some people do not achieve full incorporation of the prosthesis. Our study emphasizes the importance of physicians treating patients as whole people and moving beyond clinical and procedural ideas of success. Our findings suggest that to optimize postoperative outcomes, rehabilitation must focus not only on strengthening the joint and promoting full recovery to tasks but on modifying a person's relationship to the new joint and managing sensations of otherness to achieve full incorporation of the joint or re-embodiment.The views expressed herein are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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“…Islam and Muhamad (2021) have extended the concept of healthcare service quality by incorporating patient-centred communication. Additionally, recent studies (Behmane et al, 2021;Carter et al, 2021;Jeon et al, 2010;Lin et al, 2021;Makubalo et al, 2020;Skog€ o Nyvang et al, 2019) argue that patient-centred care is needed to address current problems of poor user satisfaction, limited understanding of patient needs, lack of patient autonomy/engagement/proactivity in care and clinical services/solutions, and the dehumanization of medical care (Miles and Mezzich, 2011;Ornstein and Kay, 2021).…”

Section: Introductionmentioning

confidence: 99%

A scale for measuring healthcare service quality incorporating patient-centred care and using a psychometric analytics framework

Rave

Figueroa²,

Echavarría³

2022

JHOM

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PurposeRecent developments in healthcare contexts increasingly emphasize patient-centred approaches to service quality measures; however, few studies consider this dimension explicitly. The present study develops and psychometrically validates a scale of healthcare service quality explicitly incorporating a patient-centred care dimension from a communicational perspective. The paper also enriches the traditional content of service quality by including equity items and presents the underlying structure of service quality in an emerging country.Design/methodology/approachThe final sample consisted of 869 healthcare users (complete cases in the service quality items derived from 917 surveys received) from Colombia. The authors used a psychometric analytics framework comprising seven processes incorporating exploratory factor analysis, structural equation modelling, and machine learning methods to examine construct plausibility, reliability, construct validity, equity, and criterion/predictive validity (e.g. explaining/predicting subjective well-being and behavioural intentions).FindingsThe final scale consists of 17 items and satisfies all psychometric properties. Its validation allows for the discovery and psychometrical confirmation of two essential dimensions: patient-centred communication (eight items) and process quality (nine items).Practical implicationsThe authors illustrate three practical uses of the scale: the possibility for diagnoses; hypothesis contrast based on confidence intervals; and estimation of the capacity of the service to satisfy specifications.Originality/valueBoth dimensions reveal users' relevant needs and complement previous studies that have focused on process aspects of healthcare service quality.

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Striving for a silent knee: a qualitative study of patients’ experiences with knee replacement surgery and their perceptions of fulfilled expectations

Cited by 9 publications

References 19 publications

How New Technology Is Improving Physical Therapy

How New Technology Is Improving Physical Therapy

“It's Not My Knee”: Understanding Ongoing Pain and Discomfort After Total Knee Replacement Through Re‐Embodiment

A scale for measuring healthcare service quality incorporating patient-centred care and using a psychometric analytics framework

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