liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement: A multi-national survey
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. (EEPO)
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. (EEPO)
Turku University, Finland.
University of Akureyri, Iceland. (EEPO)
Show others and affiliations
2014 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 11, 1491-1499 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Patient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled.

OBJECTIVES:

To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions.

DESIGN:

A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery.

SETTINGS:

Two Finnish, three Icelandic and two Swedish hospitals.

PARTICIPANTS:

The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women.

METHODS:

Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations.

RESULTS:

Patients expected more knowledge than they received (p<0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge.

CONCLUSIONS:

In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery.

Place, publisher, year, edition, pages
Elsevier, 2014. Vol. 51, no 11, 1491-1499 p.
Keyword [en]
Emotions, Empowering knowledge, Hip replacement, Knowledge expectations, Orthopaedic nursing, Patient education, Symptoms
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-109769DOI: 10.1016/j.ijnurstu.2014.03.006ISI: 000343351900009PubMedID: 24751503OAI: oai:DiVA.org:liu-109769DiVA: diva2:741256
Projects
Empowering Patient Education
Available from: 2014-08-27 Created: 2014-08-27 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Empowering knowledge and Quality of Recovery after hip or knee replacement
Open this publication in new window or tab >>Empowering knowledge and Quality of Recovery after hip or knee replacement
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Arthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today’s shorter hospital stay may be a challenge for the patients and their spouses. Patient education is linked to and promotes the recovery process and can improve the outcome after elective hip or knee replacement. Fulfilment of knowledge expectations is essential for enabling people to become empowered during the period of recovery.

Aim

The overall aim was to explore the association between empowering knowledge and patients’ quality of recovery after elective hip or knee replacement.

Methods

The design of the four papers was descriptive, prospective and comparative. Consecutively included patients and their spouses from Cyprus, Finland, Greece, Iceland and Sweden answered questionnaires before surgery and at discharge from hospital. Data was collected during the years 2009-2012. Relationships and associations between a number of factors and fulfilment of knowledge expectations, and patients’ quality of recovery were investigated. Comparisons between patients undergoing hip or knee replacement and between patients and their spouses were made.

Results

Patients and their spouses had similar knowledge expectations, and these were not fulfilled during the hospital stay. Spouses had less fulfilled knowledge expectations compared with the patients. Swedish patients and spouses had less fulfilled knowledge expectations compared with the Icelandic and Finnish ones. Patients who experienced the hospital stay as meeting their general expectations had more fulfilled knowledge expectations compared with those who did not.

Access to knowledge was the main predictor of the variance in fulfilment of knowledge expectations. Negative emotions, such as depressive state and impatience, were associated with less fulfilled knowledge expectations. For patients undergoing hip replacement, a higher level of professional education was associated with less fulfilled knowledge expectations. For patients undergoing knee replacement, a history of employment in social services or healthcare was associated with less fulfilled knowledge expectations.

Patients’ experience of greater satisfaction with care was associated with better quality of recovery for both kinds of arthroplasty. Patients with fulfilled knowledge expectations experienced better quality of recovery. The spouserelated factors, namely uncertainty and depressive state, were associated with lower quality of recovery. Factors associated with greater quality of recovery among the patients were spouses with a history of employment in social services or health care, and nurses explaining matters concerning the care and treatment for the spouses.

Conclusion

Patients and their spouses had high knowledge expectations that were not fulfilled during the hospital stay. Patients’ emotional state and their access to knowledge were important for their fulfilment of knowledge expectations. Patients’ and spouses’ emotional state also played an important role in determining the patients’ quality of recovery, and greater satisfaction with care among the patients was associated with better quality of recovery.

These results emphasise the need to detect patients and their spouses in need of support in their preparation and recovery process. It is therefore important to assess patients’ and spouses’ personal knowledge expectations, and adapt to their emotional state while fulfilling them.

The content of patient education should be personalised in future care, and informal caregivers should be seriously taken into account during the period of early recovery. The results of this thesis can be used in the development and testing of person-centred educational interventions for patients undergoing elective hip or knee replacements.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 70 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1496
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-125237 (URN)10.3384/diss.diva-125237 (DOI)978-91-7685-876-9 (ISBN)
Public defence
2016-03-18, K1, Kåkenhus, Campus Norrköping, Norrköping, 13:00 (English)
Opponent
Supervisors
Available from: 2016-02-17 Created: 2016-02-17 Last updated: 2016-02-17Bibliographically approved

Open Access in DiVA

fulltext(599 kB)352 downloads
File information
File name FULLTEXT02.pdfFile size 599 kBChecksum SHA-512
69fbaf218261b3579968b6aa4799e5d2f8802ca4fbffdd71c3a1826c6df35ee894de08232a430a58d7d0edf6c517a6bf220e0bd351a2bd536a01e6407676f2f4
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Johansson Stark, ÅsaIngadottir, BrynjaBachrach-Lindström, MargaretaUnosson, Mitra

Search in DiVA

By author/editor
Johansson Stark, ÅsaIngadottir, BrynjaBachrach-Lindström, MargaretaUnosson, Mitra
By organisation
Division of Health, Activity and CareFaculty of Health SciencesDivision of Nursing Science
In the same journal
International Journal of Nursing Studies
Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 352 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 261 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf