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Research article
Patients’ experiences of discontentment one year after total knee arthroplasty- A qualitative study
Aamir Mahdi
Orebro Universitet Institutionen for Medicinska Vetenskaper
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1807-9656
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Musculoskeletal Disorders.
Background Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are discontented without known explanation. Contentment and discontentment have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients’ experiences. Qualitative knowledge might be useful in creating strategies to decrease the discontentment rate. Methods Of the 348 patients who responded to a letter asking if they were contented or discontented with their surgery, 61 (18%) reported discontentment. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients’ experiences of discontentment one year after total knee arthroplasty. Results The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and need for buttresses. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a need for buttresses, and a lack of respect and continuity, support from health care, and information adapted to their needs. Conclusion Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient contentment after surgery.
Keywords
Content analysis, Patient contentment, Patient satisfaction, Qualitative research, Surgery, Total knee arthroplasty
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CURRENT STATUS: Published
Version 3
Posted 07 Jan, 2020
Published
On 14 Jan, 2020
No community comments so far
Submission checks complete
On 04 Jan, 2020
Editorial decision: Accept
On 03 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 31 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Editorial decision: Major revision
On 18 Nov, 2019
Review #1 received
Received 31 Oct, 2019
Reviewer #2 agreed
On 28 Oct, 2019
Review #2 received
Received 28 Oct, 2019
Reviewer #1 agreed
On 11 Oct, 2019
Editor assigned
On 09 Jul, 2019
Reviewers invited
Invitations sent on 09 Jul, 2019
Submission checks complete
On 02 Jul, 2019
Editor invited
On 02 Jul, 2019
First submitted
On 19 Jun, 2019
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Patients’ experiences of discontentment one year after total knee arthroplasty- A qualitative study
Aamir Mahdi
Orebro Universitet Institutionen for Medicinska Vetenskaper
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1807-9656
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 07 Jan, 2020
Published
On 14 Jan, 2020
No community comments so far
Submission checks complete
On 04 Jan, 2020
Editorial decision: Accept
On 03 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 31 Dec, 2019
Editor assigned
On 09 Dec, 2019
Submission checks complete
On 08 Dec, 2019
Editor invited
On 08 Dec, 2019
No comments provided
Editorial decision: Major revision
On 18 Nov, 2019
Review #1 received
Received 31 Oct, 2019
Reviewer #2 agreed
On 28 Oct, 2019
Review #2 received
Received 28 Oct, 2019
Reviewer #1 agreed
On 11 Oct, 2019
Editor assigned
On 09 Jul, 2019
Reviewers invited
Invitations sent on 09 Jul, 2019
Submission checks complete
On 02 Jul, 2019
Editor invited
On 02 Jul, 2019
First submitted
On 19 Jun, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Musculoskeletal Disorders.
Background Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are discontented without known explanation. Contentment and discontentment have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients’ experiences. Qualitative knowledge might be useful in creating strategies to decrease the discontentment rate. Methods Of the 348 patients who responded to a letter asking if they were contented or discontented with their surgery, 61 (18%) reported discontentment. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients’ experiences of discontentment one year after total knee arthroplasty. Results The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and need for buttresses. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a need for buttresses, and a lack of respect and continuity, support from health care, and information adapted to their needs. Conclusion Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient contentment after surgery.
Figure 1
Figure 2