Article

OBJECTIVES: Total knee arthroplasty is an effective intervention for people with
osteoarthritis. However, 15 to 30% of patients do not return to work, and studies
frequently fail to provide an explanation of what may lead to work disability
from workers' perspectives of the biopsychosocial factors.
This study aimed to
document workers' representations or understanding of work disability after total
knee arthroplasty. METHOD:
We adopted a qualitative approach with a narrative
inquiry method. A convenience sample of partially and fully disabled workers was
interviewed 6 to 12months after surgery with use of a semi-structured interview
guide and questionnaires on physical work demands and pain. Interviews were
audiotaped, transcribed verbatim, and anonymized. Consensus was reached on
coding, and multidisciplinary content analysis was performed. RESULTS: Among the
8 workers interviewed, all were formally employed before surgery, half were men,
and the mean age was 55years. Half were not back at work when interviewed and
felt they had received little support from their workplace, were struggling to
adapt to their new condition, and had very few adaptive strategies for trying to
get better (other than waiting), which did not make sense to them. By contrast,
the other half felt they had experienced greater improvement after surgery and
received concrete support from their workplace, which facilitated their return to
work in their view. CONCLUSION: A work disability paradigm, based on a biopsychosocial approach, should be considered in rehabilitation when workers
experience difficulty returning to work after total knee arthroplasty, because
other factors besides the patient's condition may be involved.
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Langue : ANGLAIS