Abstract

BackgroundMuch effort has been made to optimize the results of total hip arthroplasty and total knee arthroplasty. With the rapid growth of social media use, mobile apps, such as WeChat, have been considered for improving outcomes and patient satisfaction after total hip arthroplasty and total knee arthroplasty.ObjectiveWe aimed to evaluate the effectiveness of a WeChat-based community as an intervention for overall patient satisfaction.MethodsThe study was conducted among discharged in-hospital patients who received hip or knee procedures in the First Affiliated Hospital of the University of Science and Technology of China from April 2019 to January 2020. An educational online social community was constructed with the WeChat app. Participants willing to join the community were enrolled in a WeChat group and received 3 months of intervention and follow-up. Those who were not willing to use the account were included in a control group and received routine publicity via telephone, mail, and brochures. The Danish Health and Medicine Authority patient satisfaction questionnaire was used to score perioperative patient education and overall satisfaction. The contents in the group chat were analyzed using natural language processing tools.ResultsA total of 3428 patients were enrolled in the study, including 2292 in the WeChat group and 1236 in the control group. Participants in the WeChat group had higher overall satisfaction scores than those in the control group (mean 8.48, SD 1.12 vs mean 6.66, SD 1.80, P<.001). The difference between the two groups was significant for primary surgery based on subgroup stratification. To control confounding factors and explore the effects of WeChat participation as a mediating variable between perioperative patient education and overall satisfaction, hierarchical regression was utilized. An interpatient interaction model was found in the community group chat, and it contributed to overall satisfaction. Patients in the group with more interpatient interactions were more likely to have better overall satisfaction.ConclusionsThe social media–promoted educational community using WeChat was effective among joint replacement patients. Provision of more perioperative education is associated with more active patient participation in the community and therefore more patient satisfaction in terms of the overall joint procedure. Community group chat could facilitate interactions among patients and contribute to overall satisfaction.

Highlights

  • Joint diseases of the lower limb extremities influence the quality of life of elderly people and are becoming increasingly frequent owing to the rising average life expectancy

  • The social media–promoted educational community using WeChat was effective among joint replacement patients

  • A total of 3428 patients were invited to participate in the study, including 2292 in the WeChat group and 1236 in the control group

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Summary

Introduction

Joint diseases of the lower limb extremities influence the quality of life of elderly people and are becoming increasingly frequent owing to the rising average life expectancy. Total hip arthroplasty and total knee arthroplasty have been the most successful surgical treatments for end-stage arthritis. Considerable progress has been made to optimize the end-to-end process by improving the surgical technique, rehabilitation, and perioperative care. The length of hospital stay has been shortened in recent years [1], rehabilitation remains a long-term procedure and a physiopsychological challenge for patients who have undergone arthroplasty. Continuous rehabilitation guidance has proved its efficacy during long-term follow-up [2,3,4]. Much effort has been made to optimize the results of total hip arthroplasty and total knee arthroplasty. With the rapid growth of social media use, mobile apps, such as WeChat, have been considered for improving outcomes and patient satisfaction after total hip arthroplasty and total knee arthroplasty

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