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Patients' and their spouses' needs after total joint arthroplasty: a pilot study.

PURPOSE
To describe the experiences and needs of patients and their spouses during hospitalization and recovery from either total hip or total knee arthroplasty.


DESIGN
Descriptive.


SAMPLE
A purposive sample of 5 patients and their spouses in one health sciences center.


METHODS
Qualitative study using a videotaped focus group interview.


FINDINGS
Content analysis revealed two perspectives of one theme: patients and their spouses need "help making transitions." Situational and role transitions that were problematic for patients reflected distress over not being able to resume activities they enjoyed within an expected time frame. Incongruence between expectations and reality was the source of distress. As a consequence of role reversal, spouses experienced feelings of insecurity and being overwhelmed. Health and illness transitions that patients experienced were also related to incongruence between expectations of the recovery period and the reality that recovery is a slow process. Pain experienced during postdischarge recovery and rehabilitation, and problems encountered when applying information and skills learned in the hospital to the home setting were sources of concern.


CONCLUSION
The needs and experiences of patients and spouses after total joint arthroplasty reflect transitional change--changes in roles, relationships, abilities, and behaviors. Health care professionals can facilitate transitions by providing education that reflects "best case-worst case scenarios" so that expectations of the recovery process are realistic. By being the link between hospital and home, health care professionals can lend support to patients as they continue the recovery process. As a program evaluation strategy, focus groups provide useful information to health care professionals who are interested in the needs and expectations of health care consumers.


IMPLICATIONS FOR NURSING RESEARCH
Further exploration of the needs of patients and their spouses following joint replacement surgery is warranted. Use of focus group methodology might provide additional insight into the needs of this population and suggest ways in which health care professionals can modify existing programs to help these patients and their spouses make the transitions.