ARTHROPLASTY/TOTAL KNEE REPLACEMENT (TKR)

Get Complete Project Material File(s) Now! »

INTRODUCTION

In developing countries such as South Africa, osteoarthritis as a chronic musculoskeletal disease is rated among the ten most disabling diseases with symptoms occurring in 10% of men and 18% of women aged 60 years and older (OECD, 2011). Total knee replacement (TKR) surgery, as one of the arthroplasty (joint replacement) surgical procedures, is considered an established and effective treatment of knee osteoarthritis (Woolhead, Donovan, & Dieppe, 2005). Following technological advances in TKR prosthetics, the use of this procedure has increased dramatically both locally and internationally over the past few decades (Muller, 2008; Spirakis, Learmonth, & Maver, 1993).

PERSONAL AND ACADEMIC RATIONALE

In 2012, I was invited by an orthopaedic surgeon with an orthopaedic practice at a private hospital in Pretoria to join the multiprofessional team treating his TKR patients. Apart from the doctors, the team consisted of nurses, dieticians, physiotherapists, and me as an educational psychologist. As an educational psychologist registered with the Health Professions Council of South Africa (HPCSA), my scope of practice and competencies allows me to intervene, often preventatively, with people of all ages, optimising psychological insights to overcome patients‟ psychological problems(Department of Health, 2011; Psytech South Africa, 2015).

PURPOSE OF THE STUDY

The purpose of this descriptive-exploratory case study was to describe how hope theory could be used to structure I-HOPE for TKR patients. The study also sought to explore and describe the experiences of 12 TKR patients at a private hospital in Pretoria with regard to the intervention. For the purposes of this research, I-HOPE can be defined as an individual intervention based on the theory of Scioli et al. (2011). The intervention took place over four in-hospital sessions, one before and three after TKR surgery. It incorporated components of previously explored hope-based interventions that could be aligned with the theory, including elements of the hope process framework (Farran et al., 1992; Farran et al., 1995) and the universal developmental components of hope (Morse, & Doberneck, 1995). Hope is defined by Scioli et al.

RESEARCH QUESTIONS

This descriptive-exploratory study is guided by the following primary research questions. How did hope theory inform a brief hope-based in-hospital intervention for 12 TKR patients? [Descriptive research question]. What were 12 TKR patients‟ experiences of a brief hope-based in-hospital intervention at a private hospital in Pretoria?

Chapter 1 Overview of the Study
1.1 INTRODUCTION
1.2 PERSONAL AND ACADEMIC RATIONALE
1.3 PURPOSE OF THE STUDY
1.4 RESEARCH QUESTIONS
1.5 RESEARCH ASSUMPTIONS
1.6 CONCEPT CLARIFICATION
1.6.1 BRIEF HOPE-BASED INTERVENTION
1.6.2 HOPE
1.6.3 HOPELESSNESS
1.6.4 HOPE DEVELOPMENT
1.6.5 ARTHROPLASTY/TOTAL KNEE REPLACEMENT (TKR)
1.6.6 TKR PROCESS
1.7 MASTER THEORY OF THE STUDY
1.8 APPLYING THE MASTER THEORY
1.9 PARADIGMATIC PERSPECTIVES
1.10 RESEARCH METHODOLOGY
1.11 CHAPTER OUTLINE
Chapter 2 Broad Literature Review: Study Background
2.1 INTRODUCTION
2.2 POSITIONING HOPE IN THEORY
2.2.1 HISTORICAL OVERVIEW OF HOPE IN HOPE RESEARCH
2.2.2 INTERNATIONAL RESEARCH ON HOPE
2.2.2.1 Unidimensional understanding of hope
2.2.2.2 Multidimensional understanding of hope
2.2.3 NATIONAL RESEARCH ON HOPE
2.3 THE INTEGRATIVE HOPE THEORY OF SCIOLI ET AL. (2011)
2.3.1 HOPE AS ATTACHMENT MOTIVE
2.3.2 HOPE AS A SPIRITUAL MOTIVE
2.3.3 HOPE AS MASTERY MOTIVE
2.3.4 HOPE AS SURVIVAL MOTIVE
2.4 CONCLUSION
Chapter 3 A Brief Hope-based In-hospital Intervention “I-HOPE”
3.1 INTRODUCTION
3.2 EXISTING HOPE-BASED INTERVENTIONS IN A MEDICAL CONTEXT
3.2.1 HOPE-BASED NURSING INTERVENTIONS
3.2.2 PSYCHOLOGICAL INTERVENTIONS
3.2.2.1 Unidimensional psychological interventions
3.2.2.2 Multidimensional psychological interventions
3.2.3 INTERVENTION SUMMARY
3.3 HOPE STRATEGIES RELATED TO THE MASTER THEORY
3.4 I-HOPE
3.4.1 POSITIONING THE INTERVENTION IN PSYCHOLOGY
3.4.2 DESCRIBING I-HOPE
3.5 CONCLUSION
Chapter 4 Research Methodology
4.1 INTRODUCTION
4.8 ETHICAL CONSIDERATIONS
4.8.1 INFORMED CONSENT AND VOLUNTARY PARTICIPATION
4.8.2 PRIVACY, ANONYMITY, AND CONFIDENTIALITY
4.8.3 PROTECTION FROM HARM
4.8.4 ETHICS PROTOCOL DOCUMENTATION
4.9 CONCLUSION
Chapter 5 Research Results and Literature Control
5.1 INTRODUCTION
5.2 THEME 1: ACCEPTABILITY OF I-HOPE
5.2.1 SUBTHEME 1.1: AMBIVALENT FEELINGS TOWARDS I-HOPE
5.2.2 SUBTHEME 1.2: CONVINCED ABOUT THE VALUE OF I-HOPE
5.2.3 SUBTHEME 1.3: UNFULFILLED NEEDS
5.3 LITERATURE CONTROL: THEME 1 – ACCEPTABILITY
5.3.1 CONFIRMATIONS AND CONTRADICTIONS OF EXISTING KNOWLEDGE IN TERMS OF THE ACCEPTABILITY OF I-HOPE
5.3.2 NEW INSIGHTS IN TERMS OF ACCEPTABILITY
5.4 THEME 2: ATTACHMENT BENEFITS
5.4.1 SUBTHEME 2.1: TRUST/OPENNESS
5.4.2 SUBTHEME 2.2: EMOTIONAL SUPPORT
5.5 LITERATURE CONTROL: THEME 2 – ATTACHMENT
5.5.1 CONFIRMATIONS AND CONTRADICTIONS OF EXISTING KNOWLEDGE IN TERMS OF THE ATTACHMENT BENEFITS OF I-HOPE
5.5.2 NEW INSIGHTS IN TERMS OF ATTACHMENT BENEFITS
5.6 THEME 3: MASTERY BENEFITS
5.6.1 SUBTHEME 3.1: FEELING EMPOWERED
5.6.2 SUBTHEME 3.2: COLLABORATION
5.6.3 SUBTHEME 3.3: FOCUS on IMPORTANT GOALS/VALUES
5.7 LITERATURE CONTROL: THEME 3 – MASTERY BENEFITS
5.7.1 CONFIRMATIONS AND CONTRADICTIONS IN THE EXISTING KNOWLEDGE OF THE MASTERY BENEFITS OF I-HOPE
5.7.2 NEW INSIGHTS IN TERMS OF MASTERY BENEFITS
5.8 THEME 4: SURVIVAL BENEFITS
5.8.1 SUBTHEME 4.1: GENERATION OF OPTIONS/ALTERNATIVES
5.8.2 SUBTHEME 4.2: EMOTIONAL REGULATION
5.9 LITERATURE CONTROL: THEME 4 – SURVIVAL BENEFITS
5.9.1 CONFIRMATIONS AND CONTRADICTIONS OF EXISTING KNOWLEDGE ON SURVIVAL BENEFITS THROUGH I-HOPE
5.9.2 NEW INSIGHTS IN TERMS OF SURVIVAL BENEFITS
5.10 THEME 5: SPIRITUAL BENEFITS
5.10.1 SUBTHEME 5.1: COMFORT IN GOD‟S PRESENCE
5.10.2 SUBTHEME 5.2: REMINDED OF THE GOODNESS IN THE WORLD
5.11 LITERATURE CONTROL: THEME 5 – SPIRITUALITY
5.11.1 CONFIRMATIONS AND CONTRADICTIONS OF EXISTING KNOWLEDGE IN TERMS OF SPIRITUALITY BENEFITS DURING I-HOPE
5.11.2 NEW INSIGHTS
5.12 CONCLUSION
Chapter 6 Case Conclusions and Future Avenues
6.1 INTRODUCTION
6.2 REFLECTING ON THE RESEARCH QUESTIONS
6.2.1 DESCRIPTIVE RESEARCH QUESTION
6.2.2 EXPLORATORY RESEARCH QUESTION
6.2.2.1 Secondary question 1
6.2.2.2 Secondary question 2
6.3 CONTRIBUTIONS
6.3.1 CONTRIBUTIONS TO RESEARCH
6.3.2 CONTRIBUTIONS TO PRACTICE
6.4 REFLECTING ON THE POSSIBLE LIMITATIONS OF THE STUDY
6.5 RECOMMENDATIONS FOR FUTURE RESEARCH
6.6 CONCLUSION
4.2 PARADIGMATIC PERSPECTIVE AND METHODOLOGICAL PARADIGMS
4.2.1 META-THEORETICAL PARADIGM (INTERPRETIVE)
4.2.2 CRITICISM OF INTERPRETIVISM AND THE NATURALISTIC APPROACH
4.2.3 METHODOLOGICAL PARADIGM (PLAN OF EXECUTION)
4.2.4 JUSTIFICATION FOR THE QUALITATIVE CASE STUDY DESIGN
4.2.5 JUSTIFICATION FOR THE INTERPRETIVE RESEARCH PARADIGM
4.3 RESEARCH DESIGN: CASE STUDY
4.3.1 DEFINING THE CASE STUDY
4.3.1.1 Descriptive case component
4.3.1.2 Exploratory case component
4.4 BINDING THE CASE STUDY
4.4.1 SELECTION OF THE PARTICIPANTS
4.4.2 SELECTION OF THE RESEARCH SITE
4.5 DATA COLLECTION
4.5.1 PARTICIPANT DIARIES
4.5.2 INDIVIDUAL SEMISTRUCTURED INTERVIEWS
4.5.3 FOCUS GROUP INTERVIEW
4.5.4 AUDIO RECORDINGS
4.5.5 RESEARCHER‟S REFLECTIVE JOURNAL
4.6 DATA ANALYSIS AND INTERPRETATION
4.7 QUALITY CRITERIA
4.7.1 MY ROLE AS RESEARCHER
4.7.2 CREDIBILITY (TRUTH VALUE OF RESULTS)
4.7.3 DEPENDABILITY
4.7.4 CONFIRMABILITY
4.7.5 TRANSFERABILITY
4.7.6 AUTHENTICITY