title: Factors relating to perioperative experience of older persons undergoing joint replacement surgery: an integrative literature review.
abstract: OBJECTIVE
  The purpose of this literature review was to examine factors relating to the perioperative experience of older persons undergoing total hip and knee replacement surgery resulting from osteoarthritis.
  
  
  METHODS
  A literature search was undertaken using databases CINAHL, PubMed, Scopus and Web of Science to provide relevant research articles. Articles were included if they examined the factors relating to the HRQOL, QOL and perioperative experience of older persons undergoing joint replacement surgery resulting from osteoarthritis. The use of Joanna Briggs Institute's critical appraisal checklist facilitated a systematic appraisal of studies with regard to the scientific rigor of the studies.
  
  
  RESULTS
  Twenty-two publications were categorized into one main theme: "factors relating to perioperative experience" subcategorized into eight subthemes: "waiting time", "pain and disability", "mental health", "race/ethnicity, age and gender", "body image", "coping and social support", "patient education" and "care continuity".
  
  
  CONCLUSIONS
  There is a need to conduct further research to examine the perioperative experience of older persons undergoing joint replacement surgery, in particular, the lived perioperative experience of a diverse race, ethnicity and culture in an Asian population. Implications for Rehabilitation Healthcare services should remain focused on reducing waiting time as prolonged waiting time for joint replacement surgery was detrimental to patients' HRQOL. Healthcare professionals need to identify strategies to improve the perioperative pain experience through patient education on pain management and positive social support to support the process of recovery. Patients' expectations of pain and their process of recovery were closely linked to patient education. One model of patient education that was seen to be successful and linked to good post-operative outcomes was care continuity model. Being actively involved in the care continuity results in better post-operative outcomes for the patient and their family.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore , Singapore .
authors.forename: Rosy
authors.initials: R
authors.lastname: Tay Swee Cheng
authors.forename: Piyanee
authors.initials: P
authors.lastname: Klainin-Yobas
authors.forename: Desley
authors.initials: D
authors.lastname: Hegney
authors.forename: Sandra
authors.initials: S
authors.lastname: Mackey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D057189:Checklist; D003266:Continuity of Patient Care; D006801:Humans; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D059408:Pain Management; D010353:Patient Education as Topic; D011788:Quality of Life; D012944:Social Support; D014850:Waiting Lists
keywords: Hip replacement surgery; knee replacement surgery; older adults; perioperative experience