title: The lived body and the perioperative period in replacement surgery: older people's experiences.
abstract: OBJECTIVE
  This paper is a report of a study to explore older people's experiences of their lived bodies during the perioperative period for a hip or knee replacement.
  
  
  BACKGROUND
  Replacement surgery of a major joint for older people suffering from osteoarthritis is an established treatment in developed countries. Scientific knowledge is available on replacement surgery from several perspectives, but not about older people's experiences of the entire perioperative period of a replacement procedure.
  
  
  METHODS
  A qualitative longitudinal study was conducted between 2002 and 2004. Audiotaped interviews were carried out with 12 older people, on five different occasions during the perioperative period. The data were analysed using latent qualitative content analysis.
  
  
  RESULTS
  The perioperative period of a hip or knee replacement can be regarded as a process of transition which includes six critical phases. The transition was supported with the dream of becoming as able-bodied as previously in life, by having surgery. In addition, our findings revealed that the care recipients lacked knowledge about the surgical intervention as a whole.
  
  
  CONCLUSIONS
  The meaning of having joint replacement surgery was to overcome the confinement of living with a painful and unreliable body. Furthermore, care recipients struggled to regain a body in charge and control of their lives, yet from a new starting point. The care recipients were not prepared for the transitional changes through the perioperative period. Further research is needed to develop an appropriate programme for patient care during the perioperative period, in order to facilitate the process of transition.
authors.affiliation: Department of Neurobiology, Caring Sciences and Society, Division Nursing and Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden. birgitta.a.gustafsson@ki.se
authors.forename: Birgitta Akesdotter
authors.initials: BA
authors.lastname: Gustafsson
authors.forename: Sari
authors.initials: S
authors.lastname: Ponzer
authors.forename: Kristiina
authors.initials: K
authors.lastname: Heikkilä
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Ekman
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015207:Osteoarthritis, Hip / Q000523:psychology* / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000601:surgery; D019990:Perioperative Care / Q000451:nursing / Q000523:psychology*; D011795:Surveys and Questionnaires