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Title: Exploring the experiences of osteoarthritic patients awaiting hip and knee arthroplasty : informing and evaluating the effectivess of a health maintenance intervention
Author: Parsons, Gail Elizabeth
Awarding Body: University of the West of England, Bristol
Current Institution: University of the West of England, Bristol
Date of Award: 2011
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Abstract:
ABSTRACT Name: Gail Elizabeth Parsons Date: August, 2011 Title of thesis: Exploring The Experiences of Osteoarthritic Patients Awaiting Hip And Knee Arthroplasty: Informing and evaluating the effectiveness of a health maintenance intervention. Aim of the study To explore the lived experiences of patients with severe osteoarthritis of the hip and knee joint whilst awaiting primary joint replacement surgery. To utilise findings from interviews and evidence-based literature to develop a health maintenance clinic (HMC) intervention, followed by its evaluation. Methodology A mixed method design was adopted: an exploratory approach incorporating descriptive phenomenology consisting of unstructured interviews with participants awaiting their hip or knee replacement surgery, followed by a randomised control trial (RCT) to compare the existing preoperative assessment service with a health maintenance clinic intervention. Setting and sample A purposeful sample of 6 people with osteoarthritis awaiting joint replacement were interviewed. In addition, a sample of 250 people (mean age 73 years) were recruited via an orthopaedic out-patient department for the RCT following referral to the waiting list for hip or knee replacement surgery. Outcome measures The Western Ontario and McMaster Osteoarthritis Index (WOMAC) tool was used at the time of referral to waiting list and again during the preoperative assessment appointment. The Hospital Patient Satisfaction Index (HP SI) was administered at the preoperative assessment appointment. Number of surgery postponements was also recorded. Results Six themes emerged from the interview data: living and coping with pain; not being able to walk and move around; coping with every day activities; how others see me; help, advice and support whilst awaiting surgery; effect upon family, friends and helpers. The RCT revealed; no significant difference between the total WOMAC scores between the two groups. Participants attending the HMC (experimental group) were significantly more satisfied with their care. There was no relationship between satisfaction and WOMAC scores. There was a significant difference in the number of postponements of surgery between groups, with a greater proportion of participants proceeding to surgery in the experimental group. Conclusion The interview data generated new knowledge of the experiences, concerns and symptoms of individuals waiting for primary hip and knee replacement surgery. Health maintenance provision 'tailored' to the individual was revolutionary at the time of the study. Patient satisfaction was significantly high and the number of postponements of surgery was significantly less for those attending the clinic.
Supervisor: Not available Sponsor: Dudley Group of Hospitals Foundation Trust
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.573501  DOI: Not available
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