Factors relating to perioperative experience of older persons undergoing joint replacement surgery: an integrative literature review

Abstract

Purpose: The purpose of this literature review was to examine factors relating to the perioperative experience of older persons undergoing total hip and knee replacement surgery resulting from osteoarthritis. Method: A literature search was undertaken using databases CINAHL, PubMed, Scopus and Web of Science to provide relevant research articles. Articles were included if they examined the factors relating to the HRQOL, QOL and perioperative experience of older persons undergoing joint replacement surgery resulting from osteoarthritis. The use of Joanna Briggs Institute’s critical appraisal checklist facilitated a systematic appraisal of studies with regard to the scientific rigor of the studies. Results: Twenty-two publications were categorized into one main theme: “factors relating to perioperative experience” subcategorized into eight subthemes: “waiting time”, “pain and disability”, “mental health”, “race/ethnicity, age and gender”, “body image”, “coping and social support”, “patient education” and “care continuity”. Conclusion: There is a need to conduct further research to examine the perioperative experience of older persons undergoing joint replacement surgery, in particular, the lived perioperative experience of a diverse race, ethnicity and culture in an Asian population.

Implications for Rehabilitation

• Healthcare services should remain focused on reducing waiting time as prolonged waiting time for joint replacement surgery was detrimental to patients’ HRQOL.

• Healthcare professionals need to identify strategies to improve the perioperative pain experience through patient education on pain management and positive social support to support the process of recovery.

• Patients’ expectations of pain and their process of recovery were closely linked to patient education. One model of patient education that was seen to be successful and linked to good post-operative outcomes was care continuity model.

• Being actively involved in the care continuity results in better post-operative outcomes for the patient and their family.

• Hip replacement surgery
• knee replacement surgery
• older adults
• perioperative experience

Declaration of interest

None of the authors have any conflict of interest associated with this review. This review received no funding from any organisation. This work was partly completed by R.T.S.C. as part of her PhD study at Alice Lee School of Nursing Studies (ALCNS), National University of Singapore (NUS). The authors acknowledge the support of ALCNS, NUS and School of Health Sciences (Nursing) and Nanyang Polytechnic (NYP), Singapore for their support in this study.