Stergiou-Kita Mary, Grigorovich Alisa
Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Musculoskeletal Care. 2014 Jun;12(2):103-13. doi: 10.1002/msc.1065. Epub 2014 Jan 8.
To examine community reintegration following a hip or knee total joint replacement (TJR) from the perspective of rehabilitation clients.
A phenomenological frame of reference guided the present study. Ten participants who received inpatient rehabilitation completed semi-structured qualitative interviews to explore their experiences with reintegrating back into their chosen communities and the meanings that they ascribed to their reintegration. Interview data were analysed using thematic analysis. Demographic data, and information regarding participants' living situation and supports were extracted from existing databases and used to characterize the sample.
Participants revealed that reintegration after a TJR encompassed two key elements of meaning: i) engagement in meaningful activities; and ii) satisfaction levels. Additionally, the following five factors were identified as facilitators or barriers to community reintegration following a TJR: i) ongoing preparation and education; ii) confounding health issues; iii) driving and transportation; iv) personal facilitators; v) access to supports from professionals, family and friends, and community programmes.
The present study highlights the significance of engaging in meaningful activities and being satisfied in one's level of engagement to achieving a sense of community reintegration following a TJR. This suggests that reintegration post-TJR has broader meanings than just improvements in functional abilities. Practitioners are encouraged to inquire about patients' meaningful activities, support their preparedness throughout the rehabilitation process, to identify confounding health issues that may limit reintegration, consider patients' fears and anxieties and establish supports to enhance their feelings of self-efficacy and abilities to cope following a TJR.
从康复患者的角度,研究髋关节或膝关节全关节置换术(TJR)后的社区重新融入情况。
本研究采用现象学参照框架。十名接受住院康复治疗的参与者完成了半结构化定性访谈,以探讨他们重新融入所选社区的经历以及他们赋予重新融入的意义。访谈数据采用主题分析法进行分析。从现有数据库中提取人口统计学数据以及有关参与者生活状况和支持的信息,并用于描述样本特征。
参与者表示,TJR后的重新融入包含两个关键意义要素:i)参与有意义的活动;ii)满意度水平。此外,确定了以下五个因素是TJR后社区重新融入的促进因素或障碍:i)持续的准备和教育;ii)复杂的健康问题;iii)驾驶和交通;iv)个人促进因素;v)获得专业人员、家人和朋友以及社区项目的支持。
本研究强调了参与有意义的活动以及对参与程度感到满意对于TJR后实现社区重新融入感的重要性。这表明TJR后的重新融入具有比功能能力改善更广泛的意义。鼓励从业者询问患者有意义的活动,在整个康复过程中支持他们做好准备,识别可能限制重新融入的复杂健康问题,考虑患者的恐惧和焦虑,并建立支持措施以增强他们的自我效能感和TJR后应对能力。