Psychoeducational support for patients with prosthetic joint infection and their families
Funding
National Institute for Health and Social Care Delivery Research (NIHR) Research for Patient Benefit (RfPB) Ref NIHR208734.
Aim
This project aims to develop a plan and logic model for a psycho-educational intervention to reduce mental distress in patients with prosthetic joint infection. Logic models show how different parts of an intervention work to improve outcomes – such as reducing psychological distress.
Background
Prosthetic joint infection (PJI) is a serious problem that can occur after hip and knee replacement surgery. It affects 1-4% of patients and can cause pain, disability, and death. As more people have these surgeries, the number of PJI cases is expected to increase. Treatment for PJI involves further surgeries and long-term antibiotic use. This is hard on patients both physically and mentally. Patients report psychological distress similar to what cancer patients experience, but they receive no mental health support. They experience anxiety and depression, and our previous research shows they often feel unprepared and unsupported. They worry about the infection returning (which happens to 1 out of every 10 patients), having more surgeries, disability, losing their independence, and dealing with money problems. Helping patients with PJI is important to improve their quality of life and make better use of healthcare resources. Although guidelines suggest PJI patients should receive mental health support, our previous research shows NHS centres don’t have the resources to provide it. Interventions with digital components, are flexible and cost less, and have been useful in helping people with long-term health problems including psychological distress.
Design and methods
We will create a diverse group of patients, carers, healthcare workers, and researchers to help design the intervention. This is called a co-design approach. To help the group to design the intervention, we will conduct three studies: In Phase 1 we will review studies to i) understand the effectiveness of support interventions for PJI, ii) psychological impact of PJI diagnosis and treatment, iii) and evidence for online psycho-educational interventions. In Phase 2 we will analyse existing data to find the main mental health issues and needs of PJI patients. In Phase 3 we will combine our findings to develop a detailed intervention plan and logic model, using input from the co-design group. By the end of the study, we will have an intervention plan and logic model. These will be used in a future study to test how effective the intervention is.
Patient and public involvement and engagement
This study was designed with patient partners. The project includes a patient co-applicant. We will meet regularly with the co-design group, an established PPIE group, and community groups to make sure the intervention meets the needs of different and underserved populations.
Sharing the findings
Findings will be shared in accessible formats for different audiences. This includes plain English summaries, journal articles, podcasts and presentations.
Who is leading the research
Dr Andrew Moore, Associate Professor in Musculoskeletal Health Services Research, Bristol Medical School (THS), University of Bristol.
Further information
CI Email: a.j.moore@bristol.ac.uk
For more information or to get involved in this project, please contact bnssg.research@nhs.net.
The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care
Please find more information here.