BACKGROUND Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are dissatisfied without known explanation. Satisfaction and dissatisfaction have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients' experiences. Qualitative knowledge might be useful in creating strategies to decrease the dissatisfaction rate. METHODS Of the 348 patients who responded to a letter asking if they were satisfied or dissatisfied with their surgery, 61 (18%) reported discontent. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients' experiences of discontentment 1 year after total knee arthroplasty. RESULTS The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and lacking of relational supports. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a lack of relational supports, and a lack of respect and continuity, support from health care, and information adapted to their needs. CONCLUSION Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient satisfaction after surgery.

中文翻译：

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定性研究：全膝关节置换术后一年患者的不满经历。

背景技术全膝关节置换术是一种通常具有良好效果的常见手术。但是，仍然有一些患者不满意，没有已知的解释。满意和不满意以前是通过定量设计来捕捉的，但是缺乏有关这些患者经历的定性研究。定性知识可能有助于制定减少不满意率的策略。方法在348例对手术满意或不满意的信件中做出回应的患者中，有61例（18％）表示不满意。在排除有并发症的患者和拒绝参加的患者后，对44名患者进行了半结构式访谈。根据定性内容分析法对访谈进行了分析。目的是描述患者的 全膝关节置换术后1年的不满经历。结果患者对未解决的问题和新问题，独立性有限以及缺乏相关支持缺乏经验和期望。他们被疼痛和僵硬所困扰，并担心这种变化是手术导致的并发症。他们描述了无法执行日常活动和有价值的活动。他们还感到缺乏关系支持，缺乏尊重和连续性，缺乏医疗保健的支持，也没有适合他们需求的信息。结论患者的期望似乎是导致膝关节置换术后患者不满的主要因素。与以前的定量研究相比，这项定性研究揭示了未实现期望的含义。未实现期望的要素需要在员工个人层面和组织层面上进行处理。例如，增加医护人员和设施的连续性可能有助于提高手术后的患者满意度。