62. The outcomes of a phenomenological enquiry exploring the lived experiences of patients with advanced osteoarthritis whilst awaiting total hip/knee joint replacement surgery (365)

Gail Parsons, Nurse Consultant in Trauma and Orthopaedics, Russells Hall Hospital, Dudley Group of Hospitals NHS Trust, Dudley, United Kingdom
gail.parsons@dgoh.nhs.uk

Abstract:

Background

Osteoarthritis is a debilitating degenerative disease of the joints, giving rise to symptoms of pain, stiffness, impaired mobility and psychological distress (Salama & Hamer, 2007). The Surgical procedure often performed to treat this condition in the advanced stages is total joint replacement.Many individuals within the UK wait many months on NHS waiting lists for their surgery. With around 50,000 primary hip replacements and 60,000 knee replacements performed annually (NICE, 2002), and a collective total of 1,0000 performed locally, there has been very little emphasis on symptom control for patients awaiting total joint replacement.

Method

Phenomenological interviews (Giorgi, 1985) were conducted. A purposive sample of six patients were selected to explore the lived experiences of this client group, whilst waiting for their surgery. Outcomes of the interviews revealed a deficit in patient’s needs within the community in relation to symptom control for advanced osteoarthritis of the hip and knee joint. These included: uncontrolled pain, joint stiffness, immobility, lack of equipment and walking aid, unmanaged stress and anxiety, all contributing to a perceived poor quality of life. The aim was to explore the lived experiences of patients with severe osteoarthritis of the hip or knee joint whilst awaiting joint replacement surgery, promoting patient involvement, whilst utilising this information along with evidence based literature to develop a specific health maintenance intervention. Patient’s comments included: “ It depends on whether you have a good GP…. If you are fortunate then you can get some relief of pain and cope better”….. No one seems to care, really … you are just left to manage on your own and wait for the postman to call with your letter with the date of operation … life is just put on hold until the date for surgery arrives”.

Biography:

Gail is currently employed as Nurse Consultant in Trauma & Orthopaedics at The Dudley Group Of Hospitals NHS Trust in the West Midlands. She has worked within the speciality of Trauma and Orthopaedics for over 25 years. Her special interest is with patients undergoing total joint replacement surgery. Gail has presented various papers related to the speciality of orthopaedics at International conferences in the USA. Most recently she presented a paper entitled ‘Evaluation of the Nurse Consultant led clinic for patients undergoing hip and knee joint replacement surgery’ in St Louis, Missouri, USA. Gail is currently completing her PhD at University Of The West Of England, Bristol. Her thesis is entitled ‘Symptom control whilst awaiting hip/knee arthroplasty: A combined qualitative and quantitative methodological study. Gail is a member of The National Association Of Orthopaedic Nurses forum (NAON) and The Society of Orthopaedic & Trauma Nursing forum (SOTN). Gail has a passion for clinical teaching and implementing evidence based practices to improve patient care for orthopaedic patients. She has a special interest in disease specific outcome tool measures and the importance of measuring and evaluating outcomes in clinical practice.