Factors Predicting Functional Ability among Older Adults undergoing Hip and Knee Arthroplasty

Authors

  • suparb aree-ue RN, PhD, Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Inthira Roopsawang MNS, Advanced Practice Nurse (Medical-Surgical Nursing) Lecturer, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Viroj Kawinwonggowit MD. Clinical Professor, Department of Orthopaedic, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.

Keywords:

Functional ability, Functional ability improvement expectation, Hip arthroplasty, Knee arthroplasty, Quality of care transition, Total joint arthroplasty

Abstract

Total joint arthroplasty is a standard surgical procedure for reducing chronic joint pain and improving functions along with quality of life among older adults with osteoarthritis. Preoperative patients’ expectation to improve health outcomes and quality of care transitions are imperative concerns involving postoperative patient recovery.  This prospective correlational study aims were to describe the patients’ expectation to improve functional ability, quality of care transition, and health outcomes (functional ability) among older adults undergoing hip and knee arthroplasty and to investigate the predictive power of patients’ expectation along with quality of care transition to functional ability at two week follow-ups after total joint arthroplasty. Ninety-five participants scheduled for total hip and knee arthroplasty completed questionnaires, which included the Demographic and Health Information Questions, Patients’ Expectation Questionnaire, Care Transition Measure-15, and Modified Barthel Activities of Daily Index. Data were analyzed by using descriptive statistics, Pearson’s coefficient correlation, and backward regression analysis.  Results showed that the participants had a moderate level of patients’ expectation and quality of care transition, whereas a high level of functional ability was discovered. Patients’ expectation and quality of care transition were positively related to functional ability. The walking ability and social participation subscales of patients’ expectation along with management preparation and critical understanding components of quality of care transition were the predictors of functional ability. These variables were jointly predicted functional ability. A better understanding of the association among patients’ expectation, quality of care transition, and functional ability may improve the process of care and clinical outcomes among older adults undergoing hip and knee arthroplasty.

References

1. Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis and Cartilage. 2013;21(9):1145-1153.

2. Cross M, Smith E, Hoy D, et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014;73:1323-1330.

3. Ferket BS, Feldman Z, Zhou J, Oei EH, Bierma-Zeinstra SM, Mazumdar M. Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative. BMJ. 2017;356:j1131.

4. Daigle ME, Weinstein AM, Katz JN, Losina E. The costeffectiveness of total joint arthroplasty: a systematic review of published literature. Best Prac Res Clin Rheumatol. 2012;26(5):649-658.

5. Tilbury C, Haanstra TM, Leichtenberg CS, et al. Unfulfilled expectations after total hip and knee arthroplasty surgery: there is a need for better preoperative patient information and education. J Arthroplasty. 2016;31(10):2139-2145.

6. Haynes J, Nam D, Barrack RL. Obesity in total hip arthroplasty: does it make a difference? Bone Joint J. 2017;99-b(1 Supple A):31-36.

7. Loth FL, Giesinger JM, Giesinger K, et al. Impact of comorbidities on outcome after total hip arthroplasty. J Arthroplasty. 2017;32(9):2755-2761.

8. Robbins SM, Rastogi R, McLaughlin TL. Predicting acute recovery of physical function following total knee joint arthroplasty. J Arthroplasty. 2014;29(2):299-303.

9. Smith GH, Johnson S, Ballantyne JA, Dunstan E, Brenkel IJ. Predictors of excellent early outcome after total hip arthroplasty. J Ortho Surg Res. 2012;7:13. doi: 10.1186/1749-799X-7-13.

10. Mahomed NN, Liang MH, Cook EF, et al. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol. 2002;29(6): 1273-1279.

11. Allen J, Hutchinson AM, Brown R, Livingston PM. Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review. BMC Health Serv Res. 2014;14:346. doi: 10.1186/ 1472-6963-14-346.

12. Ohta B, Mola A, Rosenfeld P, Ford S. Early discharge planning and improved care transitions: pre-admission assessment for readmission risk in an elective orthopedic and cardiovascular surgical population. Int J Integr Care. 2016;16(2):10. doi: 10.5334/ijic.2260.

13. Bachmeier CJ, March LM, Cross MJ, et al. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis and Cartilage. 2001;9(2):137-146.

14. Browne JP BH, Dawson J. What is the optimal time point to assess patient-reported recovery after hip and knee replacement? A systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme. Health Qual Life Outcomes. 2013; 11:128. doi: 10.1186/1477-7525-11-128.

15. Heiberg K, Bruun-Olsen V, Mengshoel AM. Pain and recovery of physical functioning nine months after total knee arthroplasty. J Rehabil Med. 2010;42(7):614-619.

16. WHO. Global strategy and action plan on ageing and health; 2015[cited in 28 July 2018]. Available from https:// www.who.int/ageing/GSAP-Summary-EN.pdf

17. Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966; 44(3):suppl: 166-206.

18. Donabedian A. The quality of care. How can it be assessed? JAMA. 1988;260(12):1743-1748.

19. Chun J, Bafford AC. History and background of quality measurement. Clin Colon Rectal Surg. 2014;27(1):5-9.

20. Moore L, Lavoie A, Bourgeois G, Lapointe J. Donabedian’s structure-process-outcome quality of care model: validation in an integrated trauma system. J Trauma Acute Care Surg. 2015;78(6):1168-1175.

21. Coyle YM, Battles JB. Using antecedents of medical care to develop valid quality of care measures. Int J Qual Health Care. 1999;11(1):5-12.

22. Brien SE, Dixon E, Ghali WA. Measuring and reporting on quality in health care: a framework and road map for improving care. J Surgical Oncol. 2009;99(8):462-466. doi: 10.1002/jso.21188.

23. Roopsawang I, Belza B. When a care map is not a true predictor of clinical outcomes. J Gerontolol Nurs. 2015; 41(10):5-7. doi: 10.3928/00989134-20150911-22.

24. Guenther D, Schmidl S, Klatte TO, et al. Overweight and obesity in hip and knee arthroplasty: evaluation of 6078 cases. World J Orthop. 2015;6(1):137-144.

25. Jiang Y, Sanchez-Santos MT, Judge AD, Murray DW, Arden NK. Predictors of patient-reported pain and functional outcomes over 10 years after primary total knee arthroplasty: a prospective cohort study. J Arthroplasty. 2017;32(1):92-100.

26. Gonzalez Sáenz de Tejada M, Escobar A, Herrera C, García L, Aizpuru F, Sarasqueta C. Patient expectations and healthrelated quality of life outcomes following total joint replacement. Value Health. 2010;13(4):447-54. doi: 10.1111/ j.1524-4733.2009.00685.x.

27. Cross M, Lapsley H, Barcenilla A, Parker D, Coolican M, March L. Patient expectations of hip and knee joint replacement surgery and postoperative health status. Patient. 2009; 2(1):51-60.

28. Haanstra TM, van den Berg T, Ostelo RW, et al. Systematic review: do patient expectations influence treatment outcomes in total knee and total hip arthroplasty? Health Qual Life Outcomes. 2012;10:152. doi: 10.1186/1477-752510-152.

29. Scott CE BK, Clement ND, MacDonald D, Howie CR, Biant LC. Patient expectations of arthroplasty of the hip and knee. J Bone Joint Surg Br. 2012;94(7):974-981.

30. Green UR, Dearmon V, Taggart H. Improving transition of care for veterans after total joint replacement. Orthop Nurs. 2015;34(2):79-86; quiz 87-78.

31. Dossa A, Bokhour B, Hoenig H. Care transitions from the hospital to home for patients with mobility impairments: patient and family caregiver experiences. Rehabil Nurs. 2012;37(6):277-285.

32. Halawi MJ. Outcome measures in total joint arthroplasty: current status, challenges, and future directions. Orthopedics. 2015;38(8):e685-689. doi: 10.3928/0147744720150804-55.

33. Kunkel S, Rosenqvist U, Westerling R. The structure of quality systems is important to the process and outcome, an empirical study of 386 hospital departments in Sweden. BMC Health Serv Res. 2007;7:104.

34. Coleman EA. Care transition measure (CTM-15); 2006 [cited in 18 August 2017]. Available from https://caretransitions. org/wp-content/uploads/2015/08/CTM-15.pdf

35. Parry C, Mahoney E, Chalmers SA, Coleman EA. Assessing the quality of transitional care: further applications of the care transitions measure. Med Care. 2008;46(3):317-322.

36. WHO. Process of translation and adaptation of instruments. nd; https://www.who.int/substance_abuse/research_tools/ translation/en/. Accessed 5 April 2017, 2017.

37. Jitapunkul S, Kamolratanakul P, Ebrahim S. The meaning of activities of daily living in a Thai elderly population: development of a new index. Age Ageing. 1994;23(2):97-101.

38. Lenguerrand E, Wylde V, Gooberman-Hill R, et al. Trajectories of pain and function after primary hip and knee arthroplasty: the ADAPT cohort study. PloS One. 2016;11(2):e0149 306. doi: 10.1371/journal.pone.0149306. eCollection 2016.

39. Buirs LD, Van Beers LW, Scholtes VA, Pastoors T, Sprague S, Poolman RW. Predictors of physical functioning after total hip arthroplasty: a systematic review. BMJ Open. 2016;6(9): e010725. doi: 10.1136/bmjopen-2015-010725

40. Naylor MD, Kurtzman ET, Grabowski DC, Harrington C, McClellan M, Reinhard SC. Unintended consequences of steps to cut readmissions and reform payment may threaten care of vulnerable older adults. Health Aff (Millwood). 2012;31(7):1623-1632.

Downloads

Published

2019-03-27

How to Cite

1.
aree-ue suparb, Roopsawang I, Kawinwonggowit V. Factors Predicting Functional Ability among Older Adults undergoing Hip and Knee Arthroplasty. PRIJNR [Internet]. 2019 Mar. 27 [cited 2024 Apr. 26];23(2):156-69. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/120092

Issue

Section

Original paper