Abstract
BackgroundThere are increasing numbers of total hip replacements (THR) and total knee replacements (TKR) being performed in patients of working age. Providing patients undergoing TKR and THR with return to work advice might facilitate return to work. The aim of this paper is to report on the process used to systematically develop an occupational advice intervention to be delivered in hospital for those undergoing arthroplasty.MethodsThe six-step Intervention Mapping (IM) approach to development, implementation and evaluation of a theory and evidence-based interventions was followed. This paper reports on the development of the intervention covered by steps 1 to 4 of the IM process. Steps 1–3 gathered data on current practice and barriers to change using a mixed methods approach (cohort study of patients undergoing THR or TKR, stakeholder interviews, survey of practice, evidence synthesis) and provided a theoretical framework for intervention development. Step 4 used information from steps 1–3 in combination with a Delphi consensus process to develop the intervention and the associated tools and materials to facilitate its delivery.ResultsThe final intervention identified included a number of core principles including: early patient identification; delivery of key information to patients and their employers; assessment and support by a member of the orthopaedic team; procedures for escalation based on patient need; mechanisms to support communication; and training and support for the clinical teams delivering care. A total of 13 patient and 20 staff performance objectives as delivery requirements, were supported by a range of tools, roles and training resources. The intervention addressed outcomes based at the individual and interpersonal levels of the ecological model.ConclusionsFollowing the IM approach resulted in a structured and justified occupational intervention for delivery in secondary care for patients undergoing total hip and knee replacement. The feasibility of the intervention will subsequently be tested alongside further investigation to establish its effectiveness and cost-effectiveness.
Highlights
There are increasing numbers of total hip replacements (THR) and total knee replacements (TKR) being performed in patients of working age
Hip and knee osteoarthritis is associated with reduced work participation [1] and productivity [2] and impacts on likelihood of employment, household income and sickness absence [3]
The aim of this paper is to provide an overview of the intervention mapping process used in the OPAL study to systematically develop an occupational advice intervention
Summary
There are increasing numbers of total hip replacements (THR) and total knee replacements (TKR) being performed in patients of working age. Providing patients undergoing TKR and THR with return to work advice might facilitate return to work. Hip and knee osteoarthritis is associated with reduced work participation [1] and productivity [2] and impacts on likelihood of employment, household income and sickness absence [3]. Lower limb joint replacements are effective and costeffective treatments that relieve pain, restore physical function and improve health related quality of life for patients with hip and knee arthritis [8,9,10,11]. There has been a steady rise in the number of hip and knee replacements performed each year since 2000 [12, 14] and these numbers are projected to increase significantly over the 15 years [15, 16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
