Patient perspectives on home-based rehabilitation exercise and general physical activity after total hip arthroplasty: A qualitative study (PHETHAS-2) [version 5; peer review: 2 approved, 1 approved with reservations]

Background: Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is known about patients' experiences with home-based rehabilitation, and this study aimed to investigate how patients perceived home-based rehabilitation exercise and general physical activity after THA, focusing on facilitators and barriers. Methods: Semi-structured interviews of qualitative design were conducted with 22 patients who had undergone THA and who had performed home-based rehabilitation exercise. The study took place in a regional hospital in Denmark between January 2018 and May 2019. Data were analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept ‘conduct of everyday life’. The study is embedded within the Pragmatic Home-Based Exercise Therapy after Total Hip Arthroplasty-Silkeborg trial (PHETHAS-1). Results: The main theme, ‘wishing to return to the well-known everyday life’, and four subthemes were identified. Generally, participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their well-known everyday life and performing their usual general physical activities, though some lacked contact to physiotherapist. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises.  Both pain and the absence of pain were identified as barriers for doing home-based rehabilitation exercise. Pain could cause insecurity about possible medical complications, while the absence of pain could lead to the rehabilitation exercise being perceived as pointless. Conclusions: The overall goal of returning to the well-known everyday life served as a facilitator for undertaking home-based rehabilitation exercise after THA along with the flexibility regarding time and place for performing exercises. Boring exercises as well as both pain and no pain were identified as barriers to the performance of home-based rehabilitation exercise. Participants were motivated towards performing general physical activities which were part of their everyday life

Next of kin's experiences of living with a depressed person: A qualitative metasynthesis

Aim: The aim of the present study was to critically review and synthesise qualitative studies about next of kin's experiences of living with a depressed person in order to gain a better understanding of their need for professional support. Background: Having cohabitant next of kin facilitates recovery after depression. However, depression is a major emotional end social burden on the next of kin, and involving them in the treatment and rehabilitation process can increase this burden significantly. Methods: Based on the principles laid out by Sandelowski and Barroso, this qualitative metasynthesis comprised a) a systematic literature search in CINAHL, PubMed and PsycINFO databases, b) a critical evaluation of eight articles using the COREQ checklist, and c) an integrating synthesis of the articles' findings. Findings: The synthesis identified a cyclic psychosocial process accounting for the next of kin's changing recognition of their situation, their feelings and actions. Caregivers go through three phases: “searching for help and explanation”, “the debilitating period” and “recovery”. Conclusion: The views of next of kin to depressed persons on their situation and their need for support were sometimes at odds with the ill person's and the health care professionals' view

Pårørendes oplevelser af samlivet med deprimerede mennesker: en kvalitativ metasyntese

Aim: The aim of the present study was to critically review and synthesise qualitative studies about next of kin's experiences of living with a depressed person in order to gain a better understanding of their need for professional support. Background: Having cohabitant next of kin facilitates recovery after depression. However, depression is a major emotional end social burden on the next of kin, and involving them in the treatment and rehabilitation process can increase this burden significantly. Methods: Based on the principles laid out by Sandelowski and Barroso, this qualitative metasynthesis comprised a) a systematic literature search in CINAHL, PubMed and PsycINFO databases, b) a critical evaluation of eight articles using the COREQ checklist, and c) an integrating synthesis of the articles' findings. Findings: The synthesis identified a cyclic psychosocial process accounting for the next of kin's changing recognition of their situation, their feelings and actions. Caregivers go through three phases: “searching for help and explanation”, “the debilitating period” and “recovery”. Conclusion: The views of next of kin to depressed persons on their situation and their need for support were sometimes at odds with the ill person's and the health care professionals' view