title: Engaging patients in managing their health care: patient perceptions of the effect of a total joint replacement presurgical class.
abstract: OBJECTIVE
  To engage patients in managing their health care especially in relation to a total joint replacement (TJR). With the aging of the American population and the advent of new technology, there is an increase in TJRs. As the pendulum swings from evidence-based medicine to patient-centered medicine, presurgical education is preparing patients for their surgical experience. Most research studies on such education are quantitative in nature, preventing patients' voices from being heard.
  
  
  METHODS
  Using a success case narrative design, 24 patients mainly from the Kaiser Permanente Downey Medical Center were interviewed regarding their pre- and postsurgical experiences.
  
  
  RESULTS
  The study findings demonstrate that patient education, in the form of classes, with recognition of the participants' physical needs, social needs, concrete supports, and psychological needs as well as the willingness of the participants to work with their health care team can promote patient engagement and improved quality of life.
  
  
  CONCLUSIONS
  The TJR class was found to promote a sense of social connectedness and fostered participants' independence. The results of this study can assist health care professionals to improve their practice by designing presurgical programs to meet the needs of their patients.
authors.affiliation: Health Education Department, Downey Medical Center, Downey, CA, USA. mary.l.carlson@kp.org
authors.forename: Mary-Louise
authors.initials: ML
authors.lastname: Lane-Carlson
authors.forename: John
authors.initials: J
authors.lastname: Kumar
mesh_terms: D000203:Activities of Daily Living; D019643:Arthroplasty, Replacement / Q000523:psychology; D003695:Delivery of Health Care; D006801:Humans; D007407:Interviews as Topic; D010348:Patient Care Team; D010353:Patient Education as Topic; D010358:Patient Participation; D010465:Perception; D011300:Preoperative Care; D011788:Quality of Life; D012944:Social Support