Bove Allyn M, Dong Erin, Hausmann Leslie R M, Piva Sara R, Brach Jennifer S, Lewis Allen, Fitzgerald G Kelley
Department of Physical Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pennsylvania, USA.
Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA.
J Gerontol A Biol Sci Med Sci. 2022 Feb 3;77(2):e48-e55. doi: 10.1093/gerona/glab132.
The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA).
We conducted a series of qualitative focus group discussions with groups of non-Hispanic White and non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of postoperative physical therapy received, and overall satisfaction with the postoperative rehabilitation process.
Thirty-six individuals participated in focus groups. Three major themes emerged: (i) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in "prehabilitation," and often mentioned specific interventions they felt were most helpful in their recovery. (ii) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (iii) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers.
Individuals undergoing TKA can largely expect positive rehabilitation experiences postoperatively. However, some barriers to postoperative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.
这项定性焦点小组研究的目的是探讨全膝关节置换术（TKA）后康复体验及康复满意度方面的种族差异。
我们对近期接受TKA的非西班牙裔白人及非西班牙裔黑人老年人群体进行了一系列定性焦点小组讨论。我们采用扎根理论方法，即要求研究者从收集的数据中构建理论。参与者讨论了术后获得康复治疗的障碍和促进因素、对物理治疗师的看法、术后接受物理治疗的时长以及对术后康复过程的总体满意度。
36人参与了焦点小组。出现了三个主要主题：（i）参与者对TKA后的康复体验总体持积极看法。他们尤其喜欢一对一护理、参与“术前康复”的机会，并且经常提及他们认为对康复最有帮助的具体干预措施。（ii）尽管如此，获得物理治疗仍存在重大障碍。这些障碍包括疼痛管理欠佳、自付费用及其他现金支出成本，以及前往就诊的交通问题。（iii）黑人和白人参与者在康复体验上存在细微差异。黑人参与者报告称手术前的准备过程更长，且偶尔在与康复服务提供者互动时存在困难。
接受TKA的个体术后在很大程度上可预期有积极的康复体验。然而，术后物理治疗存在一些障碍，且黑人和白人患者之间可能有所不同。物理治疗师应提高对这些障碍的认识，并尽可能努力将其降至最低。
