Trajectories of need: understanding patients’ use of support during the journey through knee replacement

Abstract

Purpose: To explore how the process of undergoing and recovering from knee replacement surgery alters patients’ experiences and use of their support networks.

Methods: Ten patients having knee replacement surgery for osteoarthritis were invited to take part in in-depth interviews prior to surgery and 2–4 weeks, 6 and 12 months post-operatively. Transcripts were analyzed using Interpretative Phenomenological Analysis.

Results: Three superordinate themes were identified: (1) relationships with health professionals over the knee replacement journey; (2) implications for informal relationships and support networks and (3) providing support to others.

Conclusions: Transformation from a person with osteoarthritis to someone recovering from a surgical intervention can lead to alterations in the source, type and level of support people receive from others, and can also change the assistance that they themselves are able to offer. Findings highlight the value of the concept of interdependence to our understanding of participants’ experiences. Activity undertaken by informal support networks assists participants to cope with the consequences of osteoarthritis and surgery, and fills in the gap when more formal support is lacking. However, it is essential that provision of care is individually tailored and that formal support is adequate at times when informal support networks are unavailable.

Implications for Rehabilitation

• Activity undertaken by informal support networks can help patients who undergo knee replacement cope with the consequences of their operation; filling the void when support from health professionals is lacking.

• Contact with health professionals after surgery enhances confidence and offers reassurance; helping to facilitate the recovery process from knee replacement.

• Findings highlight, from patients’ own perspectives, the potential value of post-operative physiotherapy received soon after surgery and the possible role of long-term follow up.

• Missing or ill-timed support from health professionals can have negative psychosocial consequences for patients going through joint replacement.

Keywords:

• Healthcare
• orthopaedics
• knee replacement
• relationships
• social support

Acknowledgements

We thank the patients who took part in the study and acknowledge the invaluable support of the the RESTORE research team. We particularly thank Amanda Burston (A.B.) who conducted some of the interviews with participants.

Disclosure statement

This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research programme (RPPG-0407-10070). The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The research team acknowledge the support of the NIHR, through the Comprehensive Clinical Research Network.