Expectations and experiences of patients with osteoarthritis undergoing total joint arthroplasty: An integrative review

BACKGROUND: The effectiveness of educational interventions for osteoarthritic patients undergoing total joint arthroplasty remains inconclusive. It is essential to understand the educational needs of these patients from their perspectives. AIM: The aim of this study was to systematically summarize and synthesize osteoarthritic patients' expectations and experiences in undergoing total joint arthroplasty to identify their educational needs. DESIGN: An integrative review was conducted. METHODS: Twenty studies (13 qualitative and 7 quantitative), published between 2006 and 2016, were independently appraised by 2 reviewers using the Critical Appraisal Skills Programme checklist for qualitative studies and the Joanna Briggs Institute Critical Appraisal Tools for quantitative studies. Data were analysed using thematic analysis, and the findings were synthesized in a narrative summary. RESULTS: Six themes describing patients' preoperative and post-operative educational needs were identified: (1) preoperative anxiety, (2) unrealistic expectations of recovery, (3) post-operative pain, (4) regaining functional abilities, (5) physical and psychological sense of loss, and (6) lack of continuity of care. CONCLUSION: This review is the first to capture the osteoarthritic patients' educational needs from their perspectives. The biopsychosocial model can address the multidimensionality (biological, psychological, and social) of patients' educational needs. A robust infrastructure supporting interprofessional collaborative practice and continuity of care should be adopted to enhance current educational efforts.