Older adults’ experiences regarding discharge from hospital following orthopaedic intervention: A metasynthesis

Abstract

Purpose: To identify and synthesise qualitative literature on the older adults’ perspectives of being discharged from hospital following orthopaedic intervention. Methods: A systematic search of nine databases, for qualitative research published between 1950 and December 2010, exploring the lived experience of older adults being discharged from hospital following orthopaedic surgery was undertaken. Included papers were evaluated using the Critical Appraisal Skills Programme (CASP) quality guidelines. Data were extracted and themes synthesised, using an EXCEL spreadsheet to assist with organisation of data. Results: From the 16 papers included in the review, four themes were identified: 1) mental outlook; 2) loss of independence; 3) function and activity limitations; and 4) coping with pain. Mental outlook was central to the other three themes. Conclusions: Older adults’ experiences around hospital discharge, collected through qualitative research, provide health authorities with valuable information that could be used in care pathway planning. Health professionals involved in in-patient and community care should be aware that a perceived loss of independence, function and activity limitations, and the ability to cope with pain can influence mental outlook and consequently rehabilitation.

Implications for Rehabilitation

• Mental outlook should be discussed prior to older adults being discharged home, as maintaining a positive mental outlook facilitates a successful transition home and the confidence to increase independence.

• Coping with pain, a loss of independence, and adjusting to limitations in function and participation in activities during the early and later stages of being discharged home are problems which are frequently encountered by older adults following lower limb orthopaedic surgery.

• Consistent reinforcement of clear information may help older adults feel more confident to cope with these problems.

Keywords::

• Elderly
• aged
• orthopaedic intervention
• orthopedics
• discharge

Acknowledgements

We thank Jo Rae for her contribution to the introduction and discussion area of this manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.