title: Getting back to the future: a grounded theory study of the patient perspective of total knee joint arthroplasty.
abstract: OBJECTIVE
  The purpose of this study was to describe the experience of adults with osteoarthritis who had undergone a total knee joint arthroplasty.
  
  
  METHODS
  Grounded theory qualitative methodology was applied.
  
  
  METHODS
  Purposive and theoretical sample of nine participants.
  
  
  RESULTS
  In managing the experience of total knee joint arthroplasty, participants expressed the basic psychosocial process, "Getting back to the future." There were three main categories identified within this process, "enduring," "thinking twice," and "keeping faith." "Enduring" conceptualized the way the participants lived their daily lives. "Thinking twice" captured the participants' processes of adaptation and problem solving. "Keeping faith" was the combination of determination, trust, and optimism that sustained participants as they progressed through the total knee joint arthroplasty experience to rehabilitation.
  
  
  CONCLUSIONS
  The study provides a grounded theory of the participants' perspectives of undergoing total knee joint arthroplasty, making the process more visible for those involved in their care. Prehabilitation, postoperative care, and discharge planning can facilitate the patients' optimism and motivation to self-help. Further research to explore the process from the perspective of patients with rheumatoid arthritis and patients who have complications is recommended.
authors.affiliation: Orthopaedic Ward, North Shore Hospital, Auckland, New Zealand.
authors.forename: Kaaren
authors.initials: K
authors.lastname: Marcinkowski
authors.forename: Vita Grace
authors.initials: VG
authors.lastname: Wong
authors.forename: Denise
authors.initials: D
authors.lastname: Dignam
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation; D001294:Attitude to Health; D003289:Convalescence / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009013:Morale; D009042:Motivation; D009520:New Zealand; D015404:Nursing Methodology Research; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery; D010351:Patient Discharge; D010353:Patient Education as Topic; D019990:Perioperative Care / Q000523:psychology; D036301:Qualitative Research; D011788:Quality of Life; D020127:Recovery of Function; D012648:Self Care / Q000379:methods / Q000523:psychology; D011795:Surveys and Questionnaires; D013850:Thinking