Title: Rehabilitation exercise during hospitalization for elderly patients after knee replacement
Abstract:
Background: With the increasing proportion of the elderly population in Taiwan, degenerative knee arthritis has become more prevalent, affecting approximately 15% of older adults. Most individuals over the age of 70 exhibit symptoms of this condition. Total knee replacement (TKR) is a common surgical intervention for advanced degenerative arthritis, but postoperative challenges often arise. These include surgical wound pain, reduced muscle strength, risk of falls, thromboembolism, and limited joint mobility—all of which negatively impact patients' willingness to ambulate and participate in rehabilitation. This study seeks to explore the inpatient rehabilitation experience of elderly patients following knee replacement, to inform nursing practice and optimize care strategies.
Objective: The purpose of this study was to understand the experiences and needs of elderly patients with rehabilitation during hospitalization after knee replacement surgery.
Methods: This interview was conducted with patients who underwent knee replacement surgery for degenerative knee arthritis in the orthopedic ward of a regional hospital in northern Taiwan. From April 1 to April 30, 2024, a total of 2 patients aged 65 and above who underwent knee replacement surgery were interviewed. A one-on-one in-depth interview was conducted using the phenomenological research method of qualitative research to understand the patients' rehabilitation experience during hospitalization. Reliability and validity were established based on the Rigor analysis of qualitative research , and peer dialectical analysis was used for analysis. Colaizzi 's analysis method was adopted to summarize and form meaningful statements, and the analysis results then formed the essential meaning of this phenomenon.
Results: This interview was conducted with two elderly patients aged 65 and above who were diagnosed with degenerative knee arthritis and underwent knee replacement surgery. The average age was 68 years old. The interviews were summarized and analyzed and found that the rehabilitation experience during hospitalization included: the pain of the surgical wound increased the difficulty of rehabilitation activities, and the muscles or physical fitness could not generate enough strength to complete specific movements or activities , such as wound pain and insufficient muscle strength. The coping strategies adopted step-by-step rehabilitation exercises, self-motivation, trust in professionals, expectations for future life, and support from relatives and friends to enhance the motivation for rehabilitation.
Conclusion: Postoperative rehabilitation is a long journey that not only affects the quality of life, but also leads to family care issues. In this interview, the patients shared their experience of hospitalization and postoperative rehabilitation, and received support and care from their relatives and friends, which is the biggest key to supporting patients to increase their willingness to undergo rehabilitation. It is recommended that the rehabilitation of patients after discharge from the hospital can be further explored in the future, and comprehensive planning of follow-up care for patients after discharge from the aspects of medical care and social welfare policies can be carried out to achieve a complete holistic care process.
Keywords: Rehabilitation Exercise, elderly patients, knee replacement, knee replacement surgery.
