Research Article
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What do the patients with prosthesis related joint infections experience? A qualitative research.

Year 2022, Volume: 16 Issue: 3, 586 - 597, 26.09.2022
https://doi.org/10.21763/tjfmpc.1097949

Abstract

Introduction: Nowadays with the prolongation of life expectancy, joint prosthesis operations are performed more frequently to increase the quality of life. However, when prosthesis related infection develops, people's lives are adversely affected. In our study, it was aimed to reveal what the patients experienced in this process. Method: Qualitative research was preferred to understand the feelings, thoughts and experiences of the patients on the subject. Non-probability sampling method was used to select the individuals. Face-to-face interviews were conducted with the patients by semi-structured questions and voice recordings were taken. When the data was saturation was reached, the patient recruitment was terminated. The data were deciphered, transcribed, and analyzed with thematic approach. Results: The mean age of the patients is 64.25±7.43 (min:50, max:74) years. The patients stated that they had undergone 4-12 more operations after the first joint prosthesis. In the analysis, six main themes were identified: time, patient's agenda in treatment, patient-physician relationship, financial difficulties, patients' view of the future and receiving support. Patients described their treatment protocols with a long and complex history. In the treatment process, pain, discharge, sleep problems, deterioration of social relations, lack of referral chain, responsibilities that they could not fulfill, the burden on their caregivers, and problems in finding a job were stated as difficulties encountered in the treatment process. They stated that they became dependent on others because the treatment of these infections took a long time, their mobility after the operation was affected and they could not fulfill their basic needs and self-care. Conclusion: The long and difficult treatment process of periprosthetic infections adversely affects the well-being of patients. Patients need physical and psychosocial rehabilitation during and after treatment. With the awareness of the physicians and health authorities of these problems, different support plans can be made.

References

  • 1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from2005 to 2030. J Bone Joint Surg Am 2007; 89:780–5.
  • 2. Williams SN, Wolford ML, Bercovitz A. Hospitalization for Total Knee Replacement Among Inpatients Aged 45 and Over: United States, 2000–2010. NCHS Data Brief, No. 210, September 2015. https://www.cdc.gov/nchs/data/databriefs/db210.pdf. Accessed: 12.04.2022
  • 3. Alp E, Cevahir F, Ersoy S, Guney A. Incidence and economic burden of prosthetic joint infections in a university hospital: A report from a middle-income country. J Infect Public Health 2016;9(4):494-8.
  • 4. Tande AJ, Patel R. Prosthetic joint infection. Clin Microbiol Rev. 2014;27(2):302-45.
  • 5. Deveci MA, Şener E, Şimşek SA. Proteze bağlı enfeksiyonların tedavisinde iki aşamalı revizyon. TOTBİD Dergisi 2011;10(4):312-8.
  • 6. Cahill JL, Shadbolt B, Scarvell JM, Smith PN. Quality of life after infection in total joint replacement. J Orthop Surg (Hong Kong). 2008 Apr;16(1):58-65.
  • 7. Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 2002 Apr;23(4):183-9.
  • 8. Andersson AE, Bergh I, Karlsson J, Nilsson K. Patients’ experiences of acquiring a deep surgical site infection: An interview study. Am J Infect Control 2010 Nov;38(9):711-7.
  • 9. Moore AJ, Blom AW, Whitehouse MR, Gooberman-Hill R. Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery. BMJ Open 2015 Dec ;5(12):e009495.
  • 10. Kunutsor SK, Beswick AD, Peters TJ, Gooberman-Hill R, Whitehouse MR, Blom AW, et al. Health Care Needs and Support for Patients Undergoing Treatment for Prosthetic Joint Infection following Hip or Knee Arthroplasty: A Systematic Review. PLoS One 2017 Jan ;12(1):e0169068.
  • 11. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med 2004;351:1645–54.
  • 12. Palmer CK, Gooberman-Hill R, Blom AW, Whitehouse MR, Moore AJ. Post-surgery and recovery experiences following one- and twostage revision for prosthetic joint infection—A qualitative study of patients’ experiences. PLoS ONE 2020;15(8): e0237047.
  • 13. Moore AJ, Blom AW, Whitehouse MR, Gooberman-Hill R. Managing uncertainty - a qualitative study of surgeons' decision-making for one-stage and two-stage revision surgery for prosthetic hip joint infection. BMC Musculoskelet Disord 2017 Apr 12;18(1):154
  • 14. Walter, N.; Rupp, M.; Hierl, K.; Koch, M.; Kerschbaum, M.; Worlicek, M.; Alt, V. Long-Term Patient-Related Quality of Life after Knee Periprosthetic Joint Infection. J Clin Med 2021;10: 907.
  • 15. Helwig P, Morlock J, Oberst M, Hauschild O, Hübner J, Borde J et al. Periprosthetic joint infection--effect on quality of life. Int Orthop. 2014 May;38(5):1077-81.
  • 16. Öztürk İ, Ergin ÖN. Protez ilişkili eklem enfeksiyonları. TOTBİD Dergisi 2016; 15:74–7
  • 17. Knebel C, Menzemer J, Pohlig F, Herschbach P, Burgkart R, Obermeier A et al. Peri-Prosthetic Joint Infection of the Knee Causes High Levels of Psychosocial Distress: A Prospective Cohort Study. Surg Infect (Larchmt) 2020 Dec;21(10):877-83.
  • 18. Jeon YH, Essue B, Jan S, Wells R, Whitworth JA. Economic hardship associated with managing chronic illness: a qualitative inquiry. BMC Health Serv Res 2009 Oct 9;9:182.

Protez ilişkili eklem enfeksiyonu olan hastalar neler yaşıyorlar? Nitel araştırma.

Year 2022, Volume: 16 Issue: 3, 586 - 597, 26.09.2022
https://doi.org/10.21763/tjfmpc.1097949

Abstract

Giriş: Günümüzde yaşam süresinin uzamasıyla birlikte eklem protezi operasyonları, yaşam kalitesini arttırmak amacıyla daha sık yapılmaktadır. Ancak protez ilişkili eklem enfeksiyonu (PPE) komplikasyonu geliştiğinde kişilerin hayatları olumsuz olarak etkilenmektedir. Çalışmamızda, hastaların bu süreçte neler yaşadıklarını ortaya koymak amaçlanmıştır. Yöntem: Hastaların PPE ile ilgili duygularını, düşüncelerini ve yaşantılarını anlayabilmek amacıyla nitel çalışma yöntemi tercih edilmiştir. Kişilerin seçilmesinde olasılıklı olmayan örnekleme yöntemi kullanılmıştır. Yarı yapılandırılmış sorular hazırlanarak hastalar ile yüz yüze görüşmeler yapılmış ve ses kayıtları alınmıştır. Veriler açısından doyuma ulaşıldığında hasta alımı sonlandırılmıştır. Veriler deşifre edilerek yazıya aktarılmış, kodlanmış ve tematik analiz yapılmıştır. Bulgular: Çalışmamızdaki hastaların yaş ortalaması 64,25±7,43 (min:50, maks:74) yıldır. Hastalar takılan ilk eklem protezinden sonra 4-12 kez daha operasyon geçirdiklerini belirtmişlerdir. Analizde; zaman, tedavide hastanın gündemi, hasta hekim ilişkisi, maddi sıkıntılar, hastaların geleceğe bakışı ve destek görme olmak üzere altı ana tema saptanmıştır. Hastalar tedavi protokollerini karışık ve uzun bir öykü ile anlatmışlardır. Tedavi sürecinde genel olarak ağrı, akıntı, uyku sorunları, sosyal ilişkilerin bozulması, sevk zincirinin olmaması, kendilerinin yerine getiremedikleri sorumluluklar, onlara bakım verenin üzerindeki yük, iş bulma sorunları karşılaşılan zorluklar olarak belirtilmiştir. Bu enfeksiyonların tedavisinin uzun sürmesi, operasyon sonrası hareket kabiliyetinin etkilenmesiyle temel ihtiyaçlarını, öz bakımlarını yerine getirememeleri nedeniyle başkalarına bağımlı hale geldiklerini ifade etmişlerdir. Sonuç: Protez ilişkili enfeksiyonların uzun ve zorlu tedavi süreci, hastaların iyilik halini olumsuz yönde etkilemektedir. Hastalar tedavi sırasında ve sonrasında fiziksel ve psikososyal rehabilitasyona ihtiyaç duymaktadırlar. Tedavi sürecindeki hekimlerin ve sağlık otoritelerinin bu sorunların farkında olmasıyla, farklı destek planlamaları yapılabilir.

References

  • 1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from2005 to 2030. J Bone Joint Surg Am 2007; 89:780–5.
  • 2. Williams SN, Wolford ML, Bercovitz A. Hospitalization for Total Knee Replacement Among Inpatients Aged 45 and Over: United States, 2000–2010. NCHS Data Brief, No. 210, September 2015. https://www.cdc.gov/nchs/data/databriefs/db210.pdf. Accessed: 12.04.2022
  • 3. Alp E, Cevahir F, Ersoy S, Guney A. Incidence and economic burden of prosthetic joint infections in a university hospital: A report from a middle-income country. J Infect Public Health 2016;9(4):494-8.
  • 4. Tande AJ, Patel R. Prosthetic joint infection. Clin Microbiol Rev. 2014;27(2):302-45.
  • 5. Deveci MA, Şener E, Şimşek SA. Proteze bağlı enfeksiyonların tedavisinde iki aşamalı revizyon. TOTBİD Dergisi 2011;10(4):312-8.
  • 6. Cahill JL, Shadbolt B, Scarvell JM, Smith PN. Quality of life after infection in total joint replacement. J Orthop Surg (Hong Kong). 2008 Apr;16(1):58-65.
  • 7. Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 2002 Apr;23(4):183-9.
  • 8. Andersson AE, Bergh I, Karlsson J, Nilsson K. Patients’ experiences of acquiring a deep surgical site infection: An interview study. Am J Infect Control 2010 Nov;38(9):711-7.
  • 9. Moore AJ, Blom AW, Whitehouse MR, Gooberman-Hill R. Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery. BMJ Open 2015 Dec ;5(12):e009495.
  • 10. Kunutsor SK, Beswick AD, Peters TJ, Gooberman-Hill R, Whitehouse MR, Blom AW, et al. Health Care Needs and Support for Patients Undergoing Treatment for Prosthetic Joint Infection following Hip or Knee Arthroplasty: A Systematic Review. PLoS One 2017 Jan ;12(1):e0169068.
  • 11. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med 2004;351:1645–54.
  • 12. Palmer CK, Gooberman-Hill R, Blom AW, Whitehouse MR, Moore AJ. Post-surgery and recovery experiences following one- and twostage revision for prosthetic joint infection—A qualitative study of patients’ experiences. PLoS ONE 2020;15(8): e0237047.
  • 13. Moore AJ, Blom AW, Whitehouse MR, Gooberman-Hill R. Managing uncertainty - a qualitative study of surgeons' decision-making for one-stage and two-stage revision surgery for prosthetic hip joint infection. BMC Musculoskelet Disord 2017 Apr 12;18(1):154
  • 14. Walter, N.; Rupp, M.; Hierl, K.; Koch, M.; Kerschbaum, M.; Worlicek, M.; Alt, V. Long-Term Patient-Related Quality of Life after Knee Periprosthetic Joint Infection. J Clin Med 2021;10: 907.
  • 15. Helwig P, Morlock J, Oberst M, Hauschild O, Hübner J, Borde J et al. Periprosthetic joint infection--effect on quality of life. Int Orthop. 2014 May;38(5):1077-81.
  • 16. Öztürk İ, Ergin ÖN. Protez ilişkili eklem enfeksiyonları. TOTBİD Dergisi 2016; 15:74–7
  • 17. Knebel C, Menzemer J, Pohlig F, Herschbach P, Burgkart R, Obermeier A et al. Peri-Prosthetic Joint Infection of the Knee Causes High Levels of Psychosocial Distress: A Prospective Cohort Study. Surg Infect (Larchmt) 2020 Dec;21(10):877-83.
  • 18. Jeon YH, Essue B, Jan S, Wells R, Whitworth JA. Economic hardship associated with managing chronic illness: a qualitative inquiry. BMC Health Serv Res 2009 Oct 9;9:182.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Orijinal Articles
Authors

Arzu Nazlı 0000-0001-8859-6432

Gizem Limnili 0000-0002-2321-9182

Nilgün Özçakar 0000-0003-0434-214X

Vildan Avkan-oguz 0000-0001-7648-7730

Publication Date September 26, 2022
Submission Date April 3, 2022
Published in Issue Year 2022 Volume: 16 Issue: 3

Cite

Vancouver Nazlı A, Limnili G, Özçakar N, Avkan-oguz V. Protez ilişkili eklem enfeksiyonu olan hastalar neler yaşıyorlar? Nitel araştırma. TJFMPC. 2022;16(3):586-97.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.