Perceptions of Discharge Readiness Following Total Knee Arthroplasty: A Prospective Survey Study

Abstract

Patients undergoing total knee arthroplasty (TKA) often face challenges adapting to reduced independence after surgery, with discrepancies between discharge expectations and actual experiences. This prospective survey examined changes in readiness for discharge – knowledge, perceived coping ability, expected support, and personal status – between discharge and 1 week later, and identified predictors of post-discharge self-care knowledge. A convenience sample of 100 patients undergoing elective TKA completed the Readiness for hospital discharge scale (RHDS) 4 ± 1 hours before discharge and again on day 7 ± 2 after discharge. Wilcoxon signed-rank tests showed that knowledge about self-care (p < .001) and expected support (p < .001) increased significantly, while personal status (p = .24) and perceived coping ability (p = .54) did not change. Multiple logistic regression, with knowledge after discharge dichotomized at >8 on the RHDS knowledge subscale, identified 3 independent predictors: greater pre-discharge knowledge (OR = 3.83, 95% CI: 1.70-8.65, p = .001), higher perceived coping ability before discharge (OR = 2.11, 95% CI: 1.04-4.29, p = .038), and better personal status after discharge (OR = 1.74, 95% CI: 1.12-2.70, p = .016). The first week at home is a critical period for reinforcing knowledge and ensuring safe recovery. Integrating readiness-for-discharge assessments and coordinated hospital-home health follow-up can bridge knowledge gaps, strengthen coping, and support optimal recovery after TKA.