title: Spouse-related factors associated with quality of recovery of patients after hip or knee replacement - a Nordic perspective.
abstract: BACKGROUND
  Today's shorter hospital stays mean that patients may need support from informal caregivers during their recovery period. The responsibility for providing this support shifts from the healthcare staff to their family members fairly early in the recovery process. Spousal caregivers are considered to be the primary caregivers as their relationship with the patient is more interdependent than that of other family members or caregivers.
  
  
  OBJECTIVE
  The aim was to describe spouse-related factors that were associated with patients' quality of recovery on discharge from hospital after elective hip or knee replacement.
  
  
  METHODS
  The design was prospective, descriptive and comparative, with two measurements, before arthroplasty and on discharge.
  
  
  METHODS
  Two Finnish, three Icelandic and two Swedish university or community hospitals.
  
  
  METHODS
  The sample consisted of spouses and patients. The inclusion criteria were as follows: age ≥18 years, ability to complete the questionnaires, and ability to understand Finnish/Icelandic/Swedish. The patients were asked to identify one family member. Spouses were those defining themselves as a wife, husband or cohabiting partner. Out of 463 spouses, 306 (66%) were included. The mean age of the included spouses was 64 years and 54% of them were females.
  
  
  METHODS
  Self-reported instruments were used on expected and received knowledge, access to knowledge, emotional state and quality of recovery.
  
  
  RESULTS
  If the spouses were or had been employed in healthcare or the social services, their partner had greater quality of recovery (p = 0.006). Spouses experiencing negative emotions had partners who experienced lower quality of recovery (p <0.001). Spouses who felt that nurses had enough time for them (p = 0.044) and explained matters concerning their family members' care and treatment (p = 0.011) had partners who experienced greater quality of recovery.
  
  
  CONCLUSIONS
  Spouses' emotional state played an important role in the patients' quality of recovery (QoR), with uncertainty and depressive state as the main predictors. The importance of nurses explaining matters sufficiently to spouses was emphasized, while spouses' fulfilment of knowledge expectations was not associated with patients' recovery.
authors: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. Electronic address: asa.johansson.stark@liu.se.
authors: Åsa Johansson
authors: ÅJ
authors: Stark
authors: Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland.
authors: Sanna
authors: S
authors: Salanterä
authors: School of Health Sciences, University of Akureyri, Iceland.
authors: Arun K
authors: AK
authors: Sigurdardottir
authors: Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland; Lahti University of Applied Sciences, Lahti, Finland.
authors: Kirsi
authors: K
authors: Valkeapää
authors: Department of Medical and Health Sciences, Linköping University, Sweden.
authors: Margareta
authors: M
authors: Bachrach-Lindström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000451:nursing / Q000523:psychology*; D019645:Arthroplasty, Replacement, Knee / Q000451:nursing / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012537:Scandinavian and Nordic Countries; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Access to knowledge; Emotional state; Empowering knowledge; Fulfilment of knowledge expectations; Hip replacement; Knee replacement; Recovery; Spousal caregivers