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Patients’ experiences of discontentment one year after total knee arthroplasty: a qualitative study
Örebro University, School of Medical Sciences. Department of Orthopaedics.ORCID iD: 0000-0002-1807-9656
Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center.ORCID iD: 0000-0003-0679-5695
Örebro University, School of Medical Sciences. Department of Orthopaedics.
Örebro University, School of Health Sciences.ORCID iD: 0000-0003-0460-3864
2020 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 21, no 1, article id 29Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are dissatisfied without known explanation. Satisfaction and dissatisfaction have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients' experiences. Qualitative knowledge might be useful in creating strategies to decrease the dissatisfaction rate.

METHODS: Of the 348 patients who responded to a letter asking if they were satisfied or dissatisfied with their surgery, 61 (18%) reported discontent. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients' experiences of discontentment 1 year after total knee arthroplasty.

RESULTS: The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and lacking of relational supports. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a lack of relational supports, and a lack of respect and continuity, support from health care, and information adapted to their needs.

CONCLUSION: Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient satisfaction after surgery.

Place, publisher, year, edition, pages
BioMed Central, 2020. Vol. 21, no 1, article id 29
Keywords [en]
Content analysis, Patient contentment, Patient satisfaction, Qualitative research, Surgery, Total knee arthroplasty
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-79262DOI: 10.1186/s12891-020-3041-yISI: 000513917100003PubMedID: 31937282Scopus ID: 2-s2.0-85077838536OAI: oai:DiVA.org:oru-79262DiVA, id: diva2:1386998
Note

Funding Agencies:

Örebro Research Committee, Sweden  

Orthopaedic Department, Karlskoga Hospital, Sweden

Available from: 2020-01-20 Created: 2020-01-20 Last updated: 2020-03-04

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Mahdi, AamirSvantesson, MiaWretenberg, PerHälleberg Nyman, Maria
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