Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Collaborative Specialization

Musculoskeletal Health Research

Supervisor

Joy MacDermid

Abstract

The following study was a qualitative interpretive descriptive study aimed at investigating immediate barriers or difficulties in the lives of the community dwellers as well as modifications occurring in the daily routine activities shortly after the out-patient total shoulder arthroplasty procedure. The personal and surgical factors affecting at-home recovery were focussed alongside exploring the coping mechanisms and adaptations in everyday day life. The study mainly focused on the initial three weeks' duration after the discharge. The study followed the constructivist paradigm, adopting the interpretive description methodology. A total of 19 subjects who underwent same/ single day discharge total shoulder arthroplasty were targeted for recruitment at the Hand & Upper Limb Centre, St. Joseph’s Hospital by purposeful sampling method. The participants were interviewed either in person or over the telephone. Data was analyzed by Braun and Clarke’s Thematic Analysis Approach. The identified themes shed light upon the physical, emotional, and environmental impacts caused by a day surgery. These are further influenced by demographic characteristics such as age, gender, marital status, and type of occupation as well as surgery-related factors like reason for surgery, availability of supports, surgical literacy, and patient and caregiver education. The adaptations for basic everyday tasks were dependent upon the living conditions post-operatively. The importance of social and community supports as well as patient and caregiver education especially after a day surgery were highlighted. Preparedness for surgical procedures yield higher satisfaction and better patient experience was a noble finding.

Summary for Lay Audience

In a day shoulder arthroplasty surgery, patients are admitted, undergo the operation, and return home within twenty hours. The responsibility for recovery largely falls on the patients and their caregivers. This study aimed to identify the challenges faced and adaptations made in various aspects of life during this recovery period. To conduct the study, a constructivist paradigm was employed, emphasizing the co-construction of knowledge through participant-researcher interactions. The interpretive description method was chosen to overcome the limitations of traditional qualitative approaches, allowing a comprehensive exploration of participants' health experiences from holistic, interpretive, and relational viewpoints. Participants were recruited from the Hand and Upper Limb Centre at St. Joseph’s Hospital in London and interviewed by the first author either in person or over the phone after providing informed consent. The collected data was transcribed verbatim and subjected to thematic analysis, resulting in major themes depicting the outcomes of the dataset. The study highlighted significant difficulties and discomfort experienced by participants while carrying out daily activities, along with the adaptive techniques they employed. It underscored the vital role of social and community support in facilitating better recovery, particularly in the context of single-day surgeries. Understanding the need for a well-structured post-operative plan, especially for patients living alone without close family members, was another important finding. Pre-surgical preparedness and patient and caregiver education emerged as critical factors affecting patient satisfaction and experiences. The study revealed that day surgery had physical, emotional, and environmental impacts on a patient's life, further influenced by personal factors like demographic characteristics and surgery-related factors. In conclusion, this research sheds light on the challenges and adjustments faced by individuals undergoing day shoulder arthroplasty surgery, emphasizing the significance of supportive networks and well-planned post-operative care in enhancing the overall recovery process.

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