Discharge Planning and Challenges for Patients With Asian Lifestyles Following Total Hip Arthroplasty: National Survey Design in Japan

Abstract

This study examined discharge planning and challenges for patients following total hip arthroplasty in Japan. A cross-sectional national survey of 500 hospitals was conducted in May 2019. Discharge planning education tended to include content on dislocation prevention, including prevention while using a squat toilet and crouching down to sit on the floor or sleep on a futon on the floor-activities common in many Asian communities that require a maximum flexion of the hip joint. The challenges of discharge planning included diverse lifestyles, aging issues, lack of assistance at home, lack of consensus on dislocation prevention intervention, limitation of standardized care, interprofessional collaboration, and lack of time to educate family. Tailored discharge planning can be challenging, particularly for aged patients who practice "floor culture", i.e., sleeping, sitting and eating on the floor. Discharge planning needs to be task shifted from the surgeon to the nurse to enhance nurses' empowerment in Japan.