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Challenges in rehabilitation and continuum of care provision after knee replacement: a mixed-methods study from a low- and middle-income country
journal contribution
posted on 2023-08-15, 01:27 authored by S Pritwani, S Pandey, P Shrivastava, A Kumar, R Malhotra, Ralph MaddisonRalph Maddison, N DevasenapathyPurpose: Continuum-of-care is crucial following knee replacement. This is an understudied area in the context of low- and middle-income countries. We report findings of a mixed-methods study conducted to understand patient’s postoperative experiences in following unsupervised home-based physiotherapy protocols and healthcare provider’s experiences in providing rehabilitation care. Methods: Consecutive adults (n = 79) scheduled or had undergone knee replacement, attending an urban tertiary care hospital in India completed a 22-item questionnaire to gauge attitude towards physical rehabilitation. We conducted in-depth interviews with nine patients, ten physiotherapists, and three surgeons using a phenomenology approach. Data were interpreted using the capability, opportunity, and motivation-behaviour (COM-B) framework. Results: Patients were motivated to do exercises and valued family support during the recovery period. However, they desired physiotherapy support, especially during the early recovery period due to post-operative pain. Healthcare providers reported poor adherence with the exercise regimen and desired a mechanism to monitor patient progress after discharge. Patients and health care providers identified accessibility to rehabilitation centre as a major barrier in availing affordable and reliable physiotherapy services. Conclusion: There is a need for a continuum of care to improve patient experience during recovery and for health care providers to monitor progress and provide personalised progressive exercise therapy.
History
Journal
Disability and RehabilitationVolume
ahead-of-printLocation
EnglandPublisher DOI
ISSN
0963-8288eISSN
1464-5165Language
EnglishPublication classification
C1 Refereed article in a scholarly journalIssue
ahead-of-printPublisher
TAYLOR & FRANCIS LTDUsage metrics
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No categories selectedKeywords
Science & TechnologyLife Sciences & BiomedicineRehabilitationKnee arthroplastyphysical therapyrehabilitationcontinuum of carerehabilitation adherence>JOINT REPLACEMENTARTHROPLASTY32 Biomedical and Clinical Sciences4201 Allied Health and Rehabilitation Science4203 Health Services and Systems3202 Clinical Sciences42 Health SciencesPain ResearchBehavioral and Social ScienceClinical ResearchChronic PainHealth ServicesPhysical Rehabilitation7.1 Individual care needs8.1 Organisation and delivery of services6.7 Physical8 Health and social care services research6 Evaluation of treatments and therapeutic interventions7 Management of diseases and conditionsMusculoskeletal3 Good Health and Well BeingMedical and Health Sciences32 Biomedical and clinical sciences42 Health sciences44 Human society
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