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康复之路上的坎坷:老年人髋关节置换术后第一年的经历——一项纵向定性研究

The bumpy road to recovery: older adults' experiences during the first year after hip replacement surgery - a longitudinal qualitative study.

作者信息

Bergman Lina, Guenna Holmgren Amina, Nilsson Ulrica, Amirpour Anahita, Conte Helen, Eckerblad Jeanette

机构信息

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C3| 141 83 Hudding, Huddinge, Sweden.

出版信息

BMC Geriatr. 2025 Jul 2;25(1):483. doi: 10.1186/s12877-025-06155-6.

Abstract

BACKGROUND

Half of the older adult population worldwide is expected to undergo surgery at least once in their lifetime, with hip and knee replacements being among the most common procedures. Recovery after surgery is particularly difficult for older adults because of age-related physiological changes, an increased risk of complications, and the need for self-management at home following brief hospital stays. Emotional challenges such as fear, anxiety, and loss of independence further impact recovery, yet these aspects are often overlooked in clinical care. Currently, there is a lack of understanding of how older adults experience postoperative recovery after hip replacement surgery over time.

OBJECTIVE

To explore the experiences of recovery over time among older adults during the first year after hip replacement surgery.

METHODS

This descriptive longitudinal qualitative study included 30 older adults scheduled for hip replacement surgery at a university hospital in Sweden. Semistructured interviews were conducted twice, at fourteen days and one year after surgery. The data were analyzed using qualitative content analysis, following a Pattern-Oriented Longitudinal approach to inductively describe experiences over time.

RESULTS

The analysis resulted in one overarching theme: "the bumpy road to recovery" and three categories: physical challenges post-surgery, cognitive and emotional changes after surgery, and social and daily life adjustments. Recovery involves a balance between resting, managing symptoms, and regaining strength. For many, recovery involves physical, emotional, and cognitive challenges that feel discouraged.

CONCLUSION

This study highlights the complex and individualized recovery process after hip replacement surgery. The participants navigated physical, cognitive, emotional, and social challenges and reached a new stable state after surgery. Balancing rest and activity, managing symptoms, and maintaining social connections are key factors for successful recovery. Preoperative education and support from healthcare providers and family members are vital in improving the recovery process for older adults.

摘要

背景

预计全球老年人口中有一半人一生中至少会接受一次手术,髋关节和膝关节置换是最常见的手术之一。由于与年龄相关的生理变化、并发症风险增加以及在短暂住院后需要在家中进行自我管理,老年人术后恢复尤其困难。恐惧、焦虑和失去独立性等情绪挑战进一步影响恢复,但这些方面在临床护理中常常被忽视。目前,对于老年人髋关节置换手术后随着时间推移如何经历术后恢复缺乏了解。

目的

探讨老年人髋关节置换手术后第一年随着时间推移的恢复经历。

方法

这项描述性纵向定性研究纳入了瑞典一家大学医院计划进行髋关节置换手术的30名老年人。在术后14天和1年进行了两次半结构化访谈。采用定性内容分析方法对数据进行分析,遵循面向模式的纵向方法归纳描述随着时间推移的经历。

结果

分析得出一个总体主题:“恢复的崎岖之路”和三个类别:术后身体挑战、术后认知和情绪变化以及社会和日常生活调整。恢复需要在休息、管理症状和恢复体力之间取得平衡。对许多人来说,恢复涉及令人气馁的身体、情绪和认知挑战。

结论

本研究强调了髋关节置换手术后复杂且个体化的恢复过程。参与者应对了身体、认知、情绪和社会挑战,并在术后达到了新的稳定状态。平衡休息和活动、管理症状以及维持社会联系是成功恢复的关键因素。术前教育以及医疗保健提供者和家庭成员的支持对于改善老年人的恢复过程至关重要。

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