Jacobson Ann F, Myerscough Rodney P, Delambo Kirsten, Fleming Eileen, Huddleston Amy M, Bright Natalie, Varley Joseph D
Kent State University (KSU), College of Nursing in Kent, OH, USA.
Am J Nurs. 2008 May;108(5):54-63; quiz 63-4. doi: 10.1097/01.NAJ.0000318000.62786.fb.
Because patients' perspectives on total knee replacement (TKR) surgery have rarely been the topic of research, this study sought to describe their pre- and postoperative experiences.
Using a qualitative descriptive design, researchers collected data from a convenience sample of 27 patients who were about to undergo or had recently undergone TKR. Preoperative data were obtained in focus group sessions (n = 17); postoperative data were obtained in individual interviews (n = 10). All data-collection sessions were tape-recorded and transcribed, and transcripts were analyzed. The researchers isolated themes by identifying recurrent words and phrases and then sorted the data into thematic categories.
Four main themes emerged. First, many participants delayed surgery for months to years, despite increasing pain and limitation. Second, once participants decided to proceed with surgery, they entered a period of waiting and worrying about what would happen during and after surgery. Third, both pre- and postoperative participants struggled with the need for independence, as well as with learning to accept the new knee. And fourth, patients experienced postoperative pain associated with surgery and rehabilitation, yet reported having hope that they'd regain function.
These findings suggest that patients need to be better educated and supported before and after TKR surgery. More research is needed to shed light on how patients' experiences influence their decisions about the surgery and its outcomes.
由于患者对全膝关节置换术（TKR）手术的看法很少成为研究主题，本研究旨在描述他们术前和术后的经历。
采用定性描述性设计，研究人员从27名即将接受或最近接受TKR手术的患者的便利样本中收集数据。术前数据通过焦点小组会议（n = 17）获得；术后数据通过个人访谈（n = 10）获得。所有数据收集会议均进行录音和转录，并对转录本进行分析。研究人员通过识别反复出现的单词和短语来分离主题，然后将数据分类到主题类别中。
出现了四个主要主题。首先，尽管疼痛加剧和活动受限，许多参与者将手术推迟了数月至数年。其次，一旦参与者决定进行手术，他们就进入了一个等待和担心手术期间及术后会发生什么的时期。第三，术前和术后的参与者都在努力争取独立，以及努力学会接受新膝盖。第四，患者经历了与手术和康复相关的术后疼痛，但报告称希望恢复功能。
这些发现表明，在TKR手术前后，患者需要得到更好的教育和支持。需要更多的研究来阐明患者的经历如何影响他们对手术及其结果的决策。
