Total hip replacement - College of Occupational Therapists

Guideline recommendations
there is the option of a home assessment in the management of complex individual
needs.
Spalding conducted qualitative work with service users who had experienced
occupational therapy in pre- operative education sessions (Spalding 2004). The study
investigated the perspectives of ten service users and seven health professionals
involved in a pre- education programme consisting of a two- hour session. The session
included explanation, demonstration and opportunity for service user participation and
questions. The beneficial outcome of service user empowerment was explored,
identifying themes of confidence, trust, control, responsibility, involvement, knowledge,
support and understanding.
An earlier article by Spalding reporting on the same study, focused on pre- operative
education and anxiety (Spalding 2003), and found that service user education can
reduce anxiety. This was achieved by enabling service users to understand the
experiences that will be encountered during and after surgery; that is, the chronological
experience of total hip replacement. Spalding also identified that demonstrations were
easier to understand and facilitated learning, and that making the unknown familiar
through an opportunity to meet staff who would be involved in care on the ward was
valued by respondents.
While it is preferable that the occupational therapist who assesses the service user/
provides education is the therapist who provides the intervention post- operatively, this
may not always be feasible. This may be affected by pre- operative and surgery time
scales, and factors such as rotational staff or staff leave.
A randomised controlled trial in Finland (Johansson et al 2007) set out to determine
whether it was possible to increase service user knowledge and certainty about carerelated
issues; to reach a more empowering learning experience; and to exercise a more
positive impact on selected clinical outcomes by additional pre- admission education.
One group received standard written education and non- systematic oral education
while the intervention group received face- to- face education with nurses trained in the
concept map method, plus the written educational material. Pre- admission education
using the concept map method and written education was found to yield better
learning results than the use of written education material with non- systematic oral
education. However, it was also suggested that written information is more effective
than verbal, so services should therefore be employing both strategies for preassessment
information.
Soever et al (2010) aimed to identify the educational needs of adults having hip or
knee replacement surgery through a small qualitative study. This revealed that the
topics of interest to service users included knowing the team; condition
information and management; waiting list priorities; pre- operative activities;
preparing for admission; the rehabilitation process; functional recovery; and follow
up. They also identified factors affecting educational needs (why education is
important); that is, fears, family information needs and expectations. Soever et al
concluded by suggesting the use of a comprehensive checklist for an education
programme, the content of which may be a useful reference point for occupational
therapists.
While it is beneficial to provide information in a variety of formats to meet, for
example, learning style preferences, literacy and language skills or sensory needs, this
may not always be feasible depending on the resources available to a team.
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Occupational therapy for adults undergoing total hip replacement