Development of a Person-Centered Perioperative Care Program for Older Adults Undergoing Total Hip Arthroplasty

Abstract

            Older adults undergoing hip arthroplasty under spinal anesthesia remain conscious throughout surgery and commonly experience anxiety and reduced comfort, yet existing unit practice emphasized physical preparation only. This qualitative pilot action research aimed to develop a person-centered perioperative care program and evaluate its feasibility in this population. The study proceeded through three phases: situational analysis, program development guided by Patient-Centered Care (PCC) and Person-Centered Perioperative Nursing (PCPON) frameworks with expert review, and feasibility testing with a purposively selected target group of 10 older adults undergoing first-time hip arthroplasty in April 2026. Data were collected through observation and participant feedback alongside descriptive statistics.

            The program was delivered in full across all three phases for every participant, with no withdrawals. Participants gave feedback on reducing equipment noise and providing advance warning before instrument sounds, which was incorporated before the trial concluded. Mean anxiety scores decreased from 8.60 (S.D. = 1.07) before the program to 2.40 (S.D. = 0.84) after, and mean comfort scores increased from 53.50 (S.D. = 5.02) to 133.20 (S.D. = 3.36).

            The person-centered perioperative care program was practically implementable in this setting and showed a favorable trend in anxiety and comfort among older adults undergoing hip arthroplasty. However, as a small single-site pilot study using a pre-post design without a comparison group, these changes cannot be attributed to the program alone. The findings should therefore serve as preliminary evidence to guide program refinement and the design of a larger controlled study before conclusions on clinical effectiveness can be drawn.