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患者与物理治疗师对全髋关节置换术后早期阶段物理康复锻炼的看法:一项定性访谈研究

Patient and physical therapists' views on physical rehabilitation exercise in the early phase after total hip arthroplasty: a qualitative interview study.

作者信息

Madsen Merete Nørgaard, Mikkelsen Lone Ramer, Mark-Christensen Troels, Christiansen David Høyrup, Bandholm Thomas, Tjørnhøj-Thomsen Tine

机构信息

University Clinic for Interdisciplinary Orthopaedic Pathways (UCOP), Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark.

Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

Disabil Rehabil. 2025 Sep;47(19):5032-5043. doi: 10.1080/09638288.2025.2456594. Epub 2025 Jan 30.

Abstract

PURPOSE

Physical rehabilitation exercises (PRE) are commonly prescribed early after total hip arthroplasty (THA), but the fundamental effectiveness of PRE has been questioned. As little is known about stakeholder perceptions of PRE, the aim was to explore patients' and physical therapists' perceptions of using PRE in the early period after THA.

METHODS

A qualitative interview study was conducted. Using a semi-structured interview guide, a focus group interview with six physical therapists and individual phone interviews with 18 patients were completed. Data were transcribed verbatim and analyzed applying a reflexive thematic analysis.

RESULTS

Four main themes were identified: "Regaining everyday life," "Sense of security - trusting the health professionals," "Seeing the whole person - one size does not fit all," and "A pathway without PRE is risky."

CONCLUSIONS

PRE was perceived to play an essential role in the early postoperative phase and a stratified, individual approach was requested. PRE was considered a means to regain everyday life and improve mental and physical recovery as well as mitigate complications. Guidance from physical therapists providing PRE was highlighted to enhance the patients' sense of security. Both patients and physical therapists were concerned that a pathway without PRE would lead to poorer patient outcomes.

摘要

目的

全髋关节置换术(THA)后早期通常会开出物理康复锻炼(PRE)的处方,但PRE的基本有效性受到了质疑。由于对利益相关者对PRE的看法了解甚少,本研究旨在探讨患者和物理治疗师对THA术后早期使用PRE的看法。

方法

进行了一项定性访谈研究。使用半结构化访谈指南,完成了对六名物理治疗师的焦点小组访谈以及对18名患者的个人电话访谈。数据逐字转录,并采用反思性主题分析进行分析。

结果

确定了四个主要主题:“恢复日常生活”、“安全感——信任医疗专业人员”、“关注整体——一刀切并不适用”以及“没有PRE的康复路径存在风险”。

结论

PRE被认为在术后早期起着至关重要的作用,需要采用分层的个体化方法。PRE被视为恢复日常生活、促进身心康复以及减少并发症的一种手段。强调了提供PRE的物理治疗师的指导,以增强患者的安全感。患者和物理治疗师都担心没有PRE的康复路径会导致患者预后更差。

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