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Perm J. 2012 Summer;16(3):42-7.

Engaging patients in managing their health care: patient perceptions of the effect of a total joint replacement presurgical class.

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Health Education Department, Downey Medical Center, Downey, CA, USA.



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.


Using a success case narrative design, 24 patients mainly from the Kaiser Permanente Downey Medical Center were interviewed regarding their pre- and postsurgical experiences.


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.


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.

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