Larsson Sara, Carlsson Ingela K, Rosberg Hans-Eric, Björkman Anders, Brogren Elisabeth
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden.
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden.
J Hand Ther. 2022 Jan-Mar;35(1):41-50. doi: 10.1016/j.jht.2020.10.004. Epub 2020 Oct 24.
For patients with advanced wrist osteoarthritis (OA), total wrist fusion (TWF) is the standard surgical treatment, although total wrist arthroplasty (TWA) has become a plausible motion-preserving alternative.
To explore patients' experiences of living with advanced wrist OA before and after surgery with either a TWF or a TWA. Furthermore, we wanted to explore the expectations of surgery, appraisal of results, and the adaptation strategies used to overcome challenges in everyday life.
Qualitative descriptive.
A purposive sample of 13 patients with advanced wrist OA surgically treated with TWF (n = 7) or TWA (n = 6) was recruited. Semistructured interviews were conducted and analyzed using qualitative content analysis.
Four categories are described: the problematic wrist, the breakpoint, appraisal of the results, and adaptation to challenges in everyday life. Pain relief was the primary expectation of surgery, and involvement in the discussion regarding different surgical options had a positive effect on the appraisal of results. The participants' ability to perform tasks in everyday life appeared to be more related to their level of pain than the range of wrist motion. Successful coping strategies were developed, enabling the participants to become more independent and adapt to challenges in daily life.
Previous surgical experiences, occupation, and amount of wrist motion influenced the participants' expectations, surgical choice with either a TWF or a TWA, and the appraisal of results. The findings contribute valuable insights to both surgeons and hand therapists about the importance of having the patient's individual expectations and needs in focus.
对于晚期腕关节骨关节炎（OA）患者，全腕关节融合术（TWF）是标准的手术治疗方法，尽管全腕关节置换术（TWA）已成为一种可行的保留运动功能的替代方法。
探讨晚期腕关节OA患者在接受TWF或TWA手术前后的生活体验。此外，我们还想探讨患者对手术的期望、对手术结果的评价以及为克服日常生活中的挑战所采用的适应策略。
定性描述性研究。
选取13例接受TWF（n = 7）或TWA（n = 6）手术治疗的晚期腕关节OA患者作为目的抽样样本。进行半结构化访谈，并采用定性内容分析法进行分析。
描述了四个类别：问题手腕、转折点、对结果的评价以及对日常生活挑战的适应。缓解疼痛是手术的主要期望，参与关于不同手术选择的讨论对结果评价有积极影响。参与者在日常生活中执行任务的能力似乎与其疼痛程度而非腕关节活动范围更相关。制定了成功的应对策略，使参与者能够更加独立并适应日常生活中的挑战。
既往手术经历、职业和腕关节活动量影响了参与者的期望、选择TWF或TWA的手术决策以及对结果的评价。这些发现为外科医生和手部治疗师提供了宝贵的见解，让他们认识到关注患者个人期望和需求的重要性。
