Jäppinen A-M1,2, Hämäläinen H2, Kettunen T1,3, Piirainen A1
1University of Jyväskylä, Faculty of Sport and Health Sciences, Jyväskylä, Finland, 2Helsinki University Hospital, Internal Medicine and Rehabilitation, Helsinki, Finland, 3Central Finland Health Care District, Unit of Primary Health Care, Jyväskylä, Finland
Background: Total hip arthroplasty (THA) in a common surgical treatment for patients with osteoarthritis of the hip who have unacceptable levels of pain and/or decreased physical function and conservative treatment does not offer relief. Nowadays fast-track surgery is common shortening the time for patient education. Physiotherapy studies in THA handles commonly exercising intervention studies and there is a lack of studies about patient education in physiotherapy in THA.
Purpose: This report is a part of wider research project, which aimed to study patient education in physiotherapy in THA. The aim was to explore patients' and physiotherapists' conceptions of patient education to find deeper understanding of the phenomenon.
Methods: Patient education in physiotherapy in THA was studied through patients' (n=10) and physiotherapists'(n=7) semi structed interviews. The study design followed the patient pathway from home to hospital and back home and patients were interviewed several times along it. This report summarizes results from patients' individual interviews conducted at 3 rd. postoperative day and physiotherapists' individual and group interviews. The interviews were transcribed and analyzed by using a phenomenographic method.
Results: Four hierarchical categories of postoperative patient education in physiotherapy after THA were produced from patients' transcriptions: Trust while at hospital, Preparing for going home, Managing at home and Getting fit. Three hierarchical categories of patient education in physiotherapy in THA were produced from physiotherapists' transcriptions: Schematic physiotherapy complying with the protocol, Identifying individual rehabilitation needs and Coaching home rehabilitation.
Conclusion(s): According to patients' conceptions guidance in moving and exercising focusing on recovery at home after THA was essential. The important issue was how patient could achieve the feeling, that he/she can manage at home. This was quite expected finding, because the length of hospital stay was short and patients were responsible for their rehabilitation at home with the advices they have got in the hospital. Increasing individuality in exercise advice and interaction could change schematic physiotherapy according to physiotherapists' conceptions. Both patients and physiotherapist raised up the importance of interaction between patient and physiotherapist in guidance.Patient education in physiotherapy in THA should facilitate patient's recovery, self-care and ability for self-rehabilitation specially when rehabilitation after discharge and follow-up visits with physiotherapist are not common practice. Digital rehabilitation services could offer the cost-effective way to complete the guidance, promote patients' self-efficacy in rehabilitation and add safety at home.
Implications: Physiotherapists need tools to recognize patients' individual rehabilitation needs and the readiness to tailor patient education. As patients needing THA are getting older and might have many long-term illnesses, individuality in rehabilitation and patient education will be even more important. The results of this research project can be used in developing patient education practices in physiotherapy and physiotherapists' patient educational skills.
Keywords: Patient education, total hip arthroplasty, phenomenography
Funding acknowledgements: First author´s (AMJ) personal grant from University of Jyväskylä
Purpose: This report is a part of wider research project, which aimed to study patient education in physiotherapy in THA. The aim was to explore patients' and physiotherapists' conceptions of patient education to find deeper understanding of the phenomenon.
Methods: Patient education in physiotherapy in THA was studied through patients' (n=10) and physiotherapists'(n=7) semi structed interviews. The study design followed the patient pathway from home to hospital and back home and patients were interviewed several times along it. This report summarizes results from patients' individual interviews conducted at 3 rd. postoperative day and physiotherapists' individual and group interviews. The interviews were transcribed and analyzed by using a phenomenographic method.
Results: Four hierarchical categories of postoperative patient education in physiotherapy after THA were produced from patients' transcriptions: Trust while at hospital, Preparing for going home, Managing at home and Getting fit. Three hierarchical categories of patient education in physiotherapy in THA were produced from physiotherapists' transcriptions: Schematic physiotherapy complying with the protocol, Identifying individual rehabilitation needs and Coaching home rehabilitation.
Conclusion(s): According to patients' conceptions guidance in moving and exercising focusing on recovery at home after THA was essential. The important issue was how patient could achieve the feeling, that he/she can manage at home. This was quite expected finding, because the length of hospital stay was short and patients were responsible for their rehabilitation at home with the advices they have got in the hospital. Increasing individuality in exercise advice and interaction could change schematic physiotherapy according to physiotherapists' conceptions. Both patients and physiotherapist raised up the importance of interaction between patient and physiotherapist in guidance.Patient education in physiotherapy in THA should facilitate patient's recovery, self-care and ability for self-rehabilitation specially when rehabilitation after discharge and follow-up visits with physiotherapist are not common practice. Digital rehabilitation services could offer the cost-effective way to complete the guidance, promote patients' self-efficacy in rehabilitation and add safety at home.
Implications: Physiotherapists need tools to recognize patients' individual rehabilitation needs and the readiness to tailor patient education. As patients needing THA are getting older and might have many long-term illnesses, individuality in rehabilitation and patient education will be even more important. The results of this research project can be used in developing patient education practices in physiotherapy and physiotherapists' patient educational skills.
Keywords: Patient education, total hip arthroplasty, phenomenography
Funding acknowledgements: First author´s (AMJ) personal grant from University of Jyväskylä
Topic: Education: clinical; Orthopaedics; Professional issues
Ethics approval required: Yes
Institution: HUS Helsinki University Hospital
Ethics committee: Operative
Ethics number: 323/13/03/02/2009
All authors, affiliations and abstracts have been published as submitted.
