Trial lecture: The history and development of mixed-methods health research, and how mixed-methods can contribute today to population health and personalized care.
The ordinary opponents are:
- First opponent: Professor Rachael Gooberman-Hill, University of Bristol, UK
- Second opponent: Associate Professor Tone Marte Ljoså, University of South-Eastern Norway
- Leader of the committee: Associate Professor Peter Forde Hougaard, OsloMet
The leader of the public defence is Associate Professor Edel Jannecke Svendsen, OsloMet.
The main supervisor is Professor Alfhild Dihle, OsloMet.
The co-supervisors are Professor Simen Alexander Steindal, Lovisenberg Diaconal University College and Senior Researcher Maren Falch Lindberg, Lovisenberg Diaconal Hospital.
Thesis abstract
Knee joint replacement (arthroplasty) is a common surgical procedure offered to patients with painful end-stage knee osteoarthritis when other treatments have failed. The results are generally good with most patients experiencing reduction in pain, and functional improvement.
However, approximately 20 percent of the patients experience postsurgical pain twelve months after surgery. There is scarce knowledge about how those experiencing pain at twelve months are doing beyond the twelve month mark.
To learn more about these patients, we employed a combination of questionnaires and individual interviews to explore their experiences of living with persistent pain five to seven years after surgery.
It is important to understand which patients are at risk of developing persistent pain after surgery, and also what they perceive as most important related to their pain experiences.
With increased knowledge health professionals may provide better and individually targeted care pre- and postoperatively and may achieve better outcomes for this group of patients.
Findings
Our study showed that more anxiety pre-operatively was associated with moderate to severe pain and pain-related functional impairment five years after surgery.
Furthermore, we found that more pre-operative pain, higher number of painful sites, and low osteoarthritis severity also were factors associated with moderate to severe pain.
In the group of patients experiencing persistent pain twelve months after surgery, participants told stories of emotional struggles and long lasting painful conditions.
The burden of more painful conditions, often in addition to psychological stress, left the participants struggling, oftentimes for years before surgery.
Their stories described a vicious cycle of pain, poor physical function and a deteriorating quality of life, both physically, socially, and psychologically prior to surgery.
However, the majority of our participants experienced a decrease in pain between twelve months and five to seven years after surgery.
Although persistent knee pain still caused certain limitations for the participants, pain seemed to be less influential in their everyday lives, and no one regretted having surgery.
