A phenomenological study of patients' experiences of an orthopaedic preadmission clinic

Abstract

Preadmission clinics are seen by healthcare professionals as an important part of patients' preoperative experience. Economic benefits, through reducing length of stay postoperatively, have been realized. Relatively little research exists which informs healthcare professionals of the patients view of such clinics. Such feedback from the patients has the potential to provide important evaluative data which can be used to inform future preadmission clinics. This paper presents the findings from a small qualitative study conducted in a total hip replacement preadmission clinic in an independent hospital. Phenomenological interviews were undertaken with ten patients who attended a preadmission clinic. The findings were used by the multidisciplinary team comprising of senior clinicians within the preadmission clinic, and a number of recommendations were made and implemented to improve the clinic. Further analysis of the data also led to the team appreciating the value of the clinic for boosting patients' confidence so that they could make informed choices about their care.

Evidence-based spine preoperative education

“…At that point, patients realize they no longer are aware of their choices. Gillespie and Spalding (2007) observed in their qualitative study, that patients appreciated the educational information presented as advice rather than instruction. Patients cannot have power without choices and instructing patients fails to give patients the ability to choose.…”

“…Patients reported they appreciated enough time between preoperative education and surgery to allow them to properly prepare their home environment (Gillespie and Spalding, 2007). One patient appreciated having time to install a raised toilet seat and arranging the front steps prior to surgery to better accommodate their needs after surgery (Aquilina and Baldacchino, 2007).…”

“…Family kept patients from being overwhelmed and allowed strengthening of the patient support group, and began discharge planning (Aquilina and Baldacchino, 2007). Family helped the patient remember educational material and provided emotional support (Gillespie and Spalding, 2007).…”

“…Ninety percent of patients preferred information given verbally, but there is limited recall of verbal information (Oshodi, 2007a). Gillespie and Spalding (2007) observed that the verbal teaching session allowed patients to have a dialog with healthcare professionals. This gave patients greater knowledge to make informed decisions.…”

“…Patients must realize that they have the ability to return home safely and have the resources they need, including education. Patients should be assured that there are choices post-surgically regarding options for physical therapy, pain management, and assistive care and be given the power and confidence to make those choices (Gillespie and Spalding, 2007). Although patients must have the knowledge to successfully manage their care, current orthopedic education has traditionally failed to allow patients to realize their choices and therefore play a part in their care (Johansson et al, 2002), also failing to meet patient needs (Jacobson et al, 2008).…”