Health-related quality of life and health service use following total hip replacement surgery

Aims of the study. The study investigated health-related quality of life in relation to demographic and clinical factors, and health service use and satisfaction by older total hip replacement (THR) patients following discharge from one Australian Hospital. Rationale. Understanding health-related quality of life and patterns of service use during recovery informs caregiving and patient and family education needs for discharge planning and case management. Background. Post-discharge, older THR patients have a high rate of health services use. Few valid measures of outcomes link nursing discharge or case management to patient-identified health status or service needs. Research methods. Ward nurses conducted telephone interviews to study self-perceived health-related quality of life using Medical Outcomes Study Short-Form (SF-36) and responses to an accompanying questionnaire on demographics, service use and satisfaction at 1, 2, 4, 8, and 12 weeks postdischarge. SF-36 scores were compared with Australian population norms according to age and gender to determine the relative extent of postdischarge recovery. Results. Psychosocial recovery preceded physical recovery, which steadily improved. Physical component summary scores reached population norms and mental component summary scores exceeded norms by week 1. No differences in quality of life were found by age, but women took longer to recover physically. Those who lived alone did not have lower scores than those with residential support. General practitioners were seen most often; nursing visits were frequent only in weeks 1 and 2, specialist visits occurred at weeks 8 and 12. Allied health, hospital and pathology services were used less often. Most patients were satisfied or very satisfied with all services used. Discussion/conclusions. An almost immediate impact on quality of life was evident, probably indicating successful pain alleviation. Service use indicated adequate discharge planning and successful recovery. Having ward nurses as researchers was instrumental to continuity of communication between patients, families and service providers, which suggests increased potential for continuity of care.