An investigation of concerns of Chinese patients and their families before total knee arthroplasty

LI Yang; CAI Hong; ZHANG Ke

doi:10.3969/j.issn.2095-252X.2013.08.002

Abstract： Objective To learn about the degree of concerns of Chinese patients and their family about the upcoming total knee arthroplasty ( TKA ), postoperative rehabilitation, expectation and other relevant diagnosis and treatment procedures. Methods 128 patients who were scheduled to undergo TKA and their family members were inquired about preoperative concerns with a 61-question questionnaire. The degree of concerns was assessed by assigning a score on a scale of 1-4 ( 1=not concerned, 2=somewhat concerned, 3=very concerned and 4=extremely concerned ). Collected data were then statistically analyzed. Results The mean score of the degree of concerns of all the patients about all the items was 3.11. The top 5 concerns of Chinese patients were the ability to walk with no difficulties postoperatively ( 3.78 ), surgeons’ experience ( 3.73 ), the risk of failure in the surgery ( 3.68 ), the lifespan of joint prostheses ( 3.63 ) and the ability to take care of oneself postoperatively ( 3.63 ). The mean score of the degree of concerns of their family members was 3.18. The top 5 concerns of family members were surgeons’ experience ( 3.86 ), the ability to walk with no difficulties postoperatively ( 3.82 ), the postoperative pain relief rate ( 3.74 ), the postoperative occurrence of ankylosis ( 3.72 ), pain existing or not after discharge ( 3.72 ). The patients under 65 years old were evidently more concerned about the 6 items than those aged greater than or equal to 65 years old, including the ability to look after children postoperatively, the ability to enjoy recreations postoperatively, the lifespan of joint prostheses, the ability to ride a bike postoperatively, the ability to lift weights postoperatively and the occurrence of fractures around artificial prostheses after TKA. The scores of the degree of concerns of elderly and young patients about the occurrence of anesthetic accident were 3.71 and 3.38 respectively ( P=0.036 ). The scores of the degree of concerns of elderly and young patients about the experience of anesthetists were 3.73 and 3.47 respectively ( P=0.040 ). The scores of the degree of concerns of elderly and young patients about the pain relief rate after discharge were 3.70 and 3.41 respectively ( P=0.048 ). Elderly patients were concerned more about the occurrence of anesthetic accident, the experience of anesthetists and the pain relief rate after discharge than about other items. As to the mean degree of concerns about all the items, the differences in the age were not statistically significant, and the scores of elderly and young patients were 3.14 and 3.09 respectively ( P=0.624 ). Conclusions The top 3 concerns of Chinese patients before TKA are the postoperative functional recovery of the knee, surgeons’ experience, and the use of joint prostheses. Before the surgery, the score of the degree of concerns is higher in Chinese patients than that in western patients. Just like western patients, the ability to perform high-flexion activities is not the main concern of Chinese patients. Family members are more concerned about the postoperative functional recovery of the knee than patients themselves.