Exploring the empowerment process in hip arthroplasty patients: Insights from rehabilitation nursing

Population ageing has led to an increased incidence of hip osteoarthritis, a condition that frequently requires surgical intervention to restore functionality and relieve pain. Hip Arthroplasty (HA) constitutes a major therapeutic option; however, it may entail physical and emotional repercussions for individuals undergoing this procedure. In this context, individualized follow-up care is essential, with the Rehabilitation Nurse Specialist (RNS) assuming a central role in promoting autonomy and functional recovery.

To analyze Rehabilitation nurses' perceptions of the empowerment process for people undergoing hip arthroplasty.

A descriptive, exploratory study with a qualitative design was conducted. Data were collected through two online focus groups, guided by a semi-structured interview protocol, involving RNS providing care to individuals undergoing HA. Participants were recruited from different orthopedic care settings across two Local Health Units(LHU) in the Central region, one LHU in the Northern region, and one Integrated Continuing Care Unit in the Central region of Portugal. Data were analyzed using Bardin's content analysis framework, supported by MAXQDA Analytic Pro 2022 software.

From the analysis of the two focus groups, comprising 15 participants, two main dimensions emerged regarding the RNS's perception of the empowerment process of individuals undergoing HA for discharge home: process dynamics and associated constraints. Concerning process dynamics, emphasis was placed on the RNS's individualized intervention, encompassing preoperative preparation/home visits, patient education, functional training and motor rehabilitation, gait training, and monitoring of functional gains. Additionally, home adaptation was highlighted, including the identification of architectural barriers, physical space modification, selection of assistive devices, and implementation of readaptation strategies. Caregiver involvement, as well as pain and anxiety management, were also valued. Furthermore, interprofessional and interservice coordination was considered fundamental, with the RNS playing a leading role in ensuring continuity and quality of care. The main constraints identified included structural limitations and shortages of human resources.

RNS's perceive multiple dynamics and constraints associated with the empowerment process of individuals undergoing HA, with the latter potentially compromising intervention effectiveness. Understanding these aspects may significantly optimize standardized RNS practice in this field, enhancing continuity of care and ensuring a safe transition home.