Perceived factors shaping preoperative self-preparation among older patients undergoing total knee arthroplasty: a qualitative study
- 1School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
- 2Operating Room, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- 3Health Care Research Center for Xinjiang Regional population, Urumqi, Xinjiang, China
Abstract
Objectives: This study aimed to explore perceived factors shaping preoperative self-preparation among older patients undergoing total knee arthroplasty (TKA), drawing on the Capability, Opportunity and Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework, with a view to informing the design of targeted preoperative health education interventions.
Design: This study employed a descriptive qualitative research design. Purposive sampling was used, guided by the principle of maximum variation, taking into account factors such as age, gender, educational background and disease severity. A total of 16 participants were enrolled. Data were collected through semi-structured in-depth interviews conducted 1 day before surgery. This study employed a strategy of concurrent data collection and analysis. During data collection, the study was guided by Information Power. The data were analysed using reflexive thematic analysis.
Setting: The study was conducted in a tertiary hospital in China.
Results: Three themes with nine subthemes were generated: (1) limited preoperative self-preparation capability in older patients with TKA (difficulty coping due to multimorbidity, insufficient cognitive understanding); (2) insufficient opportunity and support for preoperative self-preparation in older patients with TKA (disparities in external support, limited access to medical and nursing care, unmet prehabilitation needs, difficulties in obtaining and identifying information); and (3) varied motivation for preoperative self-preparation in older patients with TKA (perceived benefits of preoperative self-preparation, desire to resume social participation as a driver, intertwined positive and negative emotions).
Conclusions: Preoperative self-preparation in older patients with TKA is not determined by a single factor. Healthcare providers should attend to patients’ preoperative physiological status to strengthen the foundational capacity for self-preparation; integrate and optimise diverse external support systems to enhance the external impetus for self-preparation; and address patients’ emotional concerns to stimulate the internal motivation for self-preparation, thereby facilitating comprehensive preoperative self-preparation.
Related
- Factors influencing preoperative outcome expectations in patients undergoing total knee arthroplasty: a cross-sectional observational study
- Preoperative nutritional status and its association with postoperative complications and survival in patients undergoing total hip arthroplasty: a retrospective cohort analysis
- PREOPERATIVE HEMOGLOBIN AS A PREDICTOR OF TRANSFUSION REQUIREMENT IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY
- Preoperative GLP-1 receptor agonist use is associated with lower 2-year emergency department utilization and all-cause mortality after total shoulder arthroplasty
- A smaller preoperative-to-prosthetic center of rotation shift is associated with better range of motion after bony increased-offset reverse shoulder arthroplasty: A retrospective cohort study of 97 patients by the FP-UCBM Shoulder Group
BibTeX
@article{sun2026perceived,
title = {{Perceived factors shaping preoperative self-preparation among older patients undergoing total knee arthroplasty: a qualitative study}},
author = {Jiawen Sun and Yongle Pei and Xiuhua Zhang},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-122819},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122819},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Perceived factors shaping preoperative self-preparation among older patients undergoing total knee arthroplasty: a qualitative study
AU - Jiawen Sun
AU - Yongle Pei
AU - Xiuhua Zhang
PY - 2026
DA - 2026/10/05
JO - BMJ Open
DO - 10.1136/bmjopen-2026-122819
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122819
AB - Objectives: This study aimed to explore perceived factors shaping preoperative self-preparation among older patients undergoing total knee arthroplasty (TKA), drawing on the Capability, Opportunity and Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework, with a view to informing the design of targeted preoperative health education interventions. Design: This study employed a descriptive qualitative research design. Purposive sampling was used, guided by the principle of maximum variation, taking into account factors such as age, gender, educational background and disease severity. A total of 16 participants were enrolled. Data were collected through semi-structured in-depth interviews conducted 1 day before surgery. This study employed a strategy of concurrent data collection and analysis. During data collection, the study was guided by Information Power. The data were analysed using reflexive thematic analysis. Setting: The study was conducted in a tertiary hospital in China. Results: Three themes with nine subthemes were generated: (1) limited preoperative self-preparation capability in older patients with TKA (difficulty coping due to multimorbidity, insufficient cognitive understanding); (2) insufficient opportunity and support for preoperative self-preparation in older patients with TKA (disparities in external support, limited access to medical and nursing care, unmet prehabilitation needs, difficulties in obtaining and identifying information); and (3) varied motivation for preoperative self-preparation in older patients with TKA (perceived benefits of preoperative self-preparation, desire to resume social participation as a driver, intertwined positive and negative emotions). Conclusions: Preoperative self-preparation in older patients with TKA is not determined by a single factor. Healthcare providers should attend to patients’ preoperative physiological status to strengthen the foundational capacity for self-preparation; integrate and optimise diverse external support systems to enhance the external impetus for self-preparation; and address patients’ emotional concerns to stimulate the internal motivation for self-preparation, thereby facilitating comprehensive preoperative self-preparation.
SN - 2044-6055
SN - 2044-6055
ER -