Nyvang Josefina, Hedström Margareta, Gleissman Sissel Andreassen
Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden;
Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.
Int J Qual Stud Health Well-being. 2016 Mar 31;11:30193. doi: 10.3402/qhw.v11.30193. eCollection 2016.
Knee arthroplasties are an increasingly common treatment for osteoarthritis (OA) and the main indication is pain. Previous research states, however, that 15-20% of the operated patients are dissatisfied and 20-30% have persistent pain after surgery. This study is aimed at describing patients' experiences of living with knee OA when scheduled for surgery and further their expectations for future life after surgery.
We interviewed 12 patients with knee OA scheduled for arthroplasty, using semi-structured qualitative interviews. The interviews were recorded and transcribed verbatim and analyzed using qualitative thematic analysis.
Three categories were formulated with an overriding theme: "It's not just a knee, but a whole life." The three categories were "Change from their earlier lives," "Coping with knee problems," and "Ultimate decision to undergo surgery." The main finding was that knee OA affects the whole body and self, ultimately affecting the patients' lives on many levels. Further findings were that knee OA was considered to be the central focus in the participants' lives, which limited their level of activity, their ability to function as desired, their quality of life, and their mental well-being. Although surgery was considered to be the only solution, the expectations regarding the outcome differed.
The participants were forced to change how they previously had lived their lives resulting in a feeling of loss. Thus, the experienced loss and expectations for future life must be put into the context of the individual's own personality and be taken into account when treating individuals with knee OA. The experience of living with knee OA largely varies between individuals. This mandates that patients' assessment should be considered on individual basis with regard to each patient.
膝关节置换术是治疗骨关节炎(OA)越来越常用的方法,主要指征是疼痛。然而,先前的研究表明,15%至20%的接受手术的患者不满意,20%至30%的患者术后仍有持续疼痛。本研究旨在描述计划接受手术的膝骨关节炎患者的生活经历,以及他们对术后未来生活的期望。
我们对12名计划接受关节置换术的膝骨关节炎患者进行了访谈,采用半结构化定性访谈。访谈进行了录音并逐字转录,采用定性主题分析法进行分析。
形成了三个类别,其首要主题为:“这不仅仅是一个膝盖,而是整个生活”。这三个类别分别是“与早期生活的改变”、“应对膝盖问题”以及“接受手术的最终决定”。主要发现是膝骨关节炎影响全身和自我,最终在多个层面影响患者的生活。进一步的发现是,膝骨关节炎被认为是参与者生活的核心焦点,这限制了他们的活动水平、按期望发挥功能的能力、生活质量和心理健康。尽管手术被认为是唯一的解决办法,但对结果的期望各不相同。
参与者被迫改变他们以前的生活方式,从而产生失落感。因此,在治疗膝骨关节炎患者时,必须将经历的失落感和对未来生活的期望置于个人性格的背景中加以考虑。膝骨关节炎患者的生活经历在个体之间差异很大。这就要求对每个患者的评估都应基于个体情况进行考虑。