Paper: Take a Number: The Illness Trajectory of Quality of Life and Functional Status During and Following the Wait for Total Hip and Total Knee Replacement Surgery (40th Biennial Convention (October 31st- November 4th, 2009))

Sunday, November 1, 2009

Lynda L. Mandzuk, RN, BN, MN
Surgery Program, St. Boniface General Hospital, Winnipeg, MB, Canada
Diana E. McMillan, RN, PhD
Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada
Eric R. Bohm, BEng, MD, MSc, FRCSC
University of Manitoba Joint Replacement Group, Faculty of Medicine and Faculty of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada

Learning Objective 1: describe quality of life/functional status of arthroplasty patients during their wait for surgery.

Learning Objective 2: identify health predictors across the illness trajectory for arthoplasty patients.

Increasing rates of obesity and arthritis have created a global surge in demand for hip and knee arthroplasty surgery, especially in baby boomers. Increased pressure for treatment has lead to longer surgical wait times. This longitudinal study, N = 1,228, guided by the Symptom Management Model (Dodd et al., 2001), examined quality of life (QOL) and functional status (FS) at two time points during the wait and at one year postoperative. When patients were placed on the waiting list they had compromised QOL and FS. Patients who reported below average mental and physical health at 12 months prior to surgery tended to report below average mental (r = .694) and physical health (r = .648) at one month prior to surgery, and 12 months following surgery (r = .474 and r = .302, respectively) (p < .001). Compared to total knee patients, total hip patients made the greatest gains from waitlist to follow-up in both QOL and FS. This study provides important risk insights into QOL and FS across the illness trajectory for arthroplasty patients.

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