gms | German Medical Science

Objectives: Around 1% of patients suffer from a periprosthetic joint infection (PJI) after total joint arthroplasty. In cases with a chronic PJI, often complete removal of the implant is necessary. Therefore, PJIs are associated with a great burden, not only for the patients, but also for their caring partners and families. The purpose of this study was to explore the impact of a PJI on the lives of the care-takers.

Methods: Thirty qualitative semi-structured interviews with care-takers, partners or family members of patients with PJIs were conducted. The questions for the interviews were developed by an interdisciplinary team of orthopedic surgeons, pain researchers and psychiatrists. We used these interviews to identify issues, concerns, topics or fields of interests that care-takers of patients suffering from a PJI are struggling with. Major topics, common answers and similar findings were identified using commercially available software (MAXQDA, Verbi, Germany).

Results: Mean age of care-takers was 55 years (Range 25–80). 80% were female and 20% male care-takers. 50% of the care-takers were unemployed or retired. Based on the results of this study we were able to identify four major categories that care-takers struggle with:

1.

Resources: care-takers feel generally overwhelmed by the situation they are put in. This is caused by feeling left alone with their loved ones and the challenging situation.

2.

Lack of preparation for the strains of caring for a patient with PJI: Care-takers struggle with the fact that there had been no time to prepare, neither mentally nor physically for the strains of helping and caring for a loved one/a patient suffering from a PJI. Family members often feel obliged to take care of the patients and feel the need to remain seemingly strong (mentally and physically) for the patients struggling with their newly acquired disabilities.

3.

Uncertainties/emotional strains: Care-takers live with the fear that another PJI or something devastating might happen to their loved ones again, even if it seemingly might have been overcome, e.g. after a successful revision surgery.

4.

Positive outcome: Interestingly in turn many care-takers reported that their bond with their loved ones actually grew stronger during this time of need by overcoming the daily struggles of getting around or by maintaining the daily routines and building a strong bond over lengthy talks by spending so much time together.

Conclusions: This is the first qualitative study assessing and interviewing care-takers of patients with PJI. By conducting the interviews, we were able to come to very interesting conclusions that routine patient reported outcome scores would have missed. We could identify that there is a need for an additional support system not only for patients but also for their care-takers. Therefore, this topic should be considered during revision surgery.