Development and effectivity of the exit strategy: a home-based support program for total hip and knee patients after shortened hospital stay

Summary:

As a result of a growing number of older adults and more attention for quality of life, orthopedic waiting list are increasing. A reaction to this trend is a shortening of hospital stay of total hip and knee patients. At the department of orthopedics of the University Hospital Groningen a shortened program is developed, called the Bed Oet program. Pilot research, however, shows that a considerable number of patients has the feeling they are sent home too early and feels unconfident about the rehabilitation process. Therefore, an exit strategy is developed as a support program after shortened hospital stay. This strategy is based on the social cognitive theory developed by Bandura and structured with the help of Chen’s program evaluation theory. Patients are supported for a period of six months after hospital stay by means of an exit video, newsletters, telephone contact, and involvement of a partner. An experimental study is started. The patients participating in the exit strategy are compared with the patients who receive traditional treatment. By means of questionnaires, the determinants self-efficacy, social support, and pain coping and the outcome variables ADL-functioning, physical activity behavior, and quality of life are measured. Additionally, ADL-functioning is measured objectively with the Dynaport® system. Measurements are taking place preoperatively, and 6 weeks and 6 months postoperatively.