title: Community reintegration following a total joint replacement: a pilot study.
abstract: OBJECTIVE
  To examine community reintegration following a hip or knee total joint replacement (TJR) from the perspective of rehabilitation clients.
  
  
  METHODS
  A phenomenological frame of reference guided the present study. Ten participants who received inpatient rehabilitation completed semi-structured qualitative interviews to explore their experiences with reintegrating back into their chosen communities and the meanings that they ascribed to their reintegration. Interview data were analysed using thematic analysis. Demographic data, and information regarding participants' living situation and supports were extracted from existing databases and used to characterize the sample.
  
  
  RESULTS
  Participants revealed that reintegration after a TJR encompassed two key elements of meaning: i) engagement in meaningful activities; and ii) satisfaction levels. Additionally, the following five factors were identified as facilitators or barriers to community reintegration following a TJR: i) ongoing preparation and education; ii) confounding health issues; iii) driving and transportation; iv) personal facilitators; v) access to supports from professionals, family and friends, and community programmes.
  
  
  CONCLUSIONS
  The present study highlights the significance of engaging in meaningful activities and being satisfied in one's level of engagement to achieving a sense of community reintegration following a TJR. This suggests that reintegration post-TJR has broader meanings than just improvements in functional abilities. Practitioners are encouraged to inquire about patients' meaningful activities, support their preparedness throughout the rehabilitation process, to identify confounding health issues that may limit reintegration, consider patients' fears and anxieties and establish supports to enhance their feelings of self-efficacy and abilities to cope following a TJR.
authors.affiliation: Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Stergiou-Kita
authors.forename: Alisa
authors.initials: A
authors.lastname: Grigorovich
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010865:Pilot Projects; D011184:Postoperative Period; D012919:Social Behavior; D012944:Social Support
keywords: Total joint replacement; community integration; phenomenology; qualitative