全髋关节或膝关节置换术后患者亚急性疼痛管理的经验:一项定性研究。

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2023-12-01 Epub Date: 2023-10-31 DOI:10.1002/msc.1837
Shania Liu, Hadi A Almansour, Lily Pham, Furkan Genel, Ian A Harris, Asad E Patanwala, Sam Adie, Jennifer Stevens, Geraldine Hassett, Kate Luckie, Jonathan Penm, Justine Naylor
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引用次数: 0

摘要

背景:全髋关节和膝关节置换术是世界范围内常见的手术,但对亚急性期(定义为出院至术后3个月)的疼痛管理知之甚少。本研究旨在确定患者在全髋关节置换术或膝关节置换术后亚急性疼痛管理的经验、促进因素和障碍。方法:在2022年6月至8月期间,对全髋关节或膝关节置换术后的患者进行了半结构化访谈。参与者来自两所大都市三级医院。访谈录音并逐字转录。采用归纳专题法对数据进行分析,以确定共同主题。结果:总共对髋关节或膝关节置换术后的患者进行了30次访谈。确定了四个主要主题:(i)手术前的身体状况(关节状况、镇痛药的使用、年龄和听力);二态度和知识(动机、人生观、服药态度、个人基准和知识);(iii)社会民族文化因素(家庭和社区联系、语言和宗教),以及(iv)卫生系统支持(卫生专业人员提供的教育、药物、服务、工作人员和费用)。结论:参与者髋关节或膝关节置换术后亚急性疼痛的经历是由多方面因素决定的。通过在术后阿片类药物减量期间增加教育和支持,以及在亚急性期转向生物-心理-社会方法进行疼痛管理来增强患者能力的策略,可能会改善患者和卫生系统的结果。
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Patients' experiences of subacute pain management following total hip or knee arthroplasty: A qualitative study.

Background: Total hip and knee arthroplasties are common surgeries performed worldwide, but the management of pain during the subacute period (defined as hospital discharge to 3 months postoperatively) is poorly understood. This study aimed to determine patients' experiences, facilitators and barriers to subacute pain management following total hip or knee arthroplasty.

Methods: Semi-structured interviews with a purposive sample of patients following total hip or knee arthroplasty were conducted between June and August 2022. Participants were recruited from two tertiary metropolitan hospitals. Interviews were audio-recorded and transcribed verbatim. Data were analysed using an inductive thematic approach to identify common themes.

Results: In total, 30 interviews were conducted with patients following hip or knee arthroplasty. Four main themes were identified: (i) Physical constitution before surgery (joint condition, analgesic use, age, and hearing); (ii) Attitude and knowledge (motivation, outlook on life, attitude towards taking medications, individual benchmarking, and knowledge); (iii) Socio-ethno-cultural factors (family and community connection, language, and religion), and (iv) Health-system support (health-professional delivered education, medications, services, staff, and costs).

Conclusions: Participants' experiences of subacute pain following hip or knee arthroplasty were shaped by multidimensional factors. Strategies to empower patients through increased education and support during postoperative opioid tapering as well as a shift to a biopsychosocial approach to pain management during the subacute period may improve patient and health-system outcomes.

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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
期刊最新文献
Improving Musculoskeletal Health by Incorporating Equity, Diversity, and Inclusion Approaches Into Research Practices. Patients' Experiences, Satisfaction and Quality of Life With Physiotherapy Follow-Up After Total Knee Arthroplasty: A Phenomenological Qualitative Study Protocol. Physical Activity, Kinesiophobia, Pain Catastrophizing, Body Awareness, Depression and Disease Activity in Patients With Ankylosing Spondylitis and Rheumatoid Arthritis: A Cross-Sectional Explorative Study. Physiotherapists' Treatment Strategies and Delineation of Areas of Responsibility for People With Musculoskeletal Conditions and Comorbidities in Private Physiotherapy Practice: A Qualitative Study. The Effect of Telerehabilitation-Based Self-Management Programme on Individuals With Scleroderma.
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