Abstract
Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are frequently performed surgeries worldwide. Preoperative education enhances patient physiotherapy management and satisfaction and should be tailored to patients’ educational needs. Limited research is available regarding the preoperative educational needs for these patients.Objectives: To determine the extent of preoperative education received and the preoperative educational needs of patients undergoing THA and TKA.Method: A structured interview utilising a self-developed questionnaire was used and included questions exploring preoperative education, educational needs, method of education and health care professional providing education. A total of 14 THA and 36 TKA patients, 2–4 days post-operatively at private hospitals in Bloemfontein, were conveniently sampled.Results: All participants had arthroplasties because of osteoarthritis. All participants with THA and 35 (98%) participants with TKA received preoperative education from orthopaedic surgeons, and 8 (57%) participants with THA and 9 (25%) participants with TKA received preoperative education from physiotherapists. Education was mostly given as pamphlets months before the surgery. Participants received the least amount of information regarding exercises, especially preoperative exercise, pain relief and activities of daily living.Conclusion: This study highlights the need for improvement in patient engagement and education, together with enhanced health care practitioner communication and collaboration. Patient centeredness and individualised THA and TKA preoperative education programmes are recognised as a necessary attribute of quality health care and can lead to improved THA and TKA outcomes. The importance of exercise as part of preoperative interprofessional education in the management of THA and TKA should be emphasised as exercise is the cornerstone for rehabilitation of THA and TKA.Clinical implications: This study aimed to emphasise the importance of tailored preoperative education for THA and TKA patients to improve patient outcomes.
Highlights
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are amongst the most frequently performed surgeries in developed (Cram et al 2012; Learmonth, Young & Rorabeck 2007) and developing countries (Jain et al 2004)
In South Africa, THA and TKA patient admissions in the private sector have increased by 31% and 53%, respectively, and the current private health care costs have escalated by approximately 300% (Ngoepe 2016) in the past decade
All of the THA and 35 (98%) of the TKA participants indicated that they received their preoperative education from an orthopaedic surgeon with only 8 (57%) of the THA and 9 (25%) of the TKA participants receiving preoperative education from a physiotherapist
Summary
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are amongst the most frequently performed surgeries in developed (Cram et al 2012; Learmonth, Young & Rorabeck 2007) and developing countries (Jain et al 2004). Arthroplasty is an effective intervention to reduce pain and improve quality of life and functional limitations in individuals living with symptomatic degenerative hip and knee disorders (Carr et al 2012; Pivec et al 2012; Soever et al 2010). Because of the escalation in current health care costs, it seems reasonable to hypothesise that there should be a shift in patient management in order to improve patient outcomes and reduce health care costs. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are frequently performed surgeries worldwide. Limited research is available regarding the preoperative educational needs for these patients
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