Objective: Because patients' perspectives on total knee replacement (TKR) surgery have rarely been the topic of research, this study sought to describe their pre- and postoperative experiences.
Methods: Using a qualitative descriptive design, researchers collected data from a convenience sample of 27 patients who were about to undergo or had recently undergone TKR. Preoperative data were obtained in focus group sessions (n = 17); postoperative data were obtained in individual interviews (n = 10). All data-collection sessions were tape-recorded and transcribed, and transcripts were analyzed. The researchers isolated themes by identifying recurrent words and phrases and then sorted the data into thematic categories.
Results: Four main themes emerged. First, many participants delayed surgery for months to years, despite increasing pain and limitation. Second, once participants decided to proceed with surgery, they entered a period of waiting and worrying about what would happen during and after surgery. Third, both pre- and postoperative participants struggled with the need for independence, as well as with learning to accept the new knee. And fourth, patients experienced postoperative pain associated with surgery and rehabilitation, yet reported having hope that they'd regain function.
Conclusions: These findings suggest that patients need to be better educated and supported before and after TKR surgery. More research is needed to shed light on how patients' experiences influence their decisions about the surgery and its outcomes.
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http://dx.doi.org/10.1097/01.NAJ.0000318000.62786.fb | DOI Listing |
JAMA Dermatol
January 2025
Department of Dermatology, University of Pennsylvania, Philadelphia.
Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.
Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.
JAMA Otolaryngol Head Neck Surg
January 2025
Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas.
Importance: Facial synkinesis refers to pathologic cocontraction and baseline hypertonicity of muscles innervated by the facial nerve, commonly attributed to the aberrant regeneration of nerve fibers following injury. The pathomechanism and optimal treatment of facial synkinesis remain unclear. The goal of this review is to highlight current understanding of the epidemiology, pathophysiology, clinical presentation, assessment, and treatment of facial synkinesis.
View Article and Find Full Text PDFACS Nano
January 2025
Jilin Provincial Key Laboratory of Nutrition and Functional Food, College of Food Science and Engineering, Jilin University, Changchun 130062, China.
Orally targeting nanostrategies of multiple nutraceuticals have attracted increasing attention in ulcerative colitis (UC) therapy for superior patient compliance, cost-effectiveness, and biocompatibility. However, the actual targeting delivery and bioefficacy of nutraceuticals are extremely restricted by their poor solubility, interior gastrointestinal retention, and base permeability. Herein, we developed controllable colon-targeting nanoparticles (NPs) composed of a quaternary ammonium chitosan (HTCC) shell and succinic acid-modified γ-cyclodextrin (SACD) core for precise UC treatment.
View Article and Find Full Text PDFInstr Course Lect
January 2025
Orthopaedic surgery has a higher risk of iatrogenic nerve injury than other surgical specialties. The initial management depends on the etiology, which requires early recognition and an appreciation for the injury. Three perspectives are given to guide the surgeon through the initial management of these devastating complications.
View Article and Find Full Text PDFA A Pract
January 2025
Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Background: Evaluations performed before the day of surgery at perioperative clinics have been shown to reduce patient mortality and hospital lengths of stay. These clinics are becoming increasingly adopted worldwide. As the number of older patients undergoing surgery continues to increase, understanding the perspectives of this patient population regarding the preoperative evaluation process is essential to tailor care to their needs and preferences.
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