Summary
People get older and often have numerous chronic diseases. Despite their disabilities, people want to manage their own health and care and participate in society. In this respect the concept of “health” is about the ability to self-manage and adapt to physical, social and emotional challenges in life. Getting a total hip arthroplasty (THA) might be such a challenge. For frail elderly, hospitalization and surgery may be a major life event that could have serious effect on people’s functioning and adaptability. Where many people show a quick and satisfactorily postoperative recovery, some (older) people, may face many barriers in their recovery. Unfortunately interventions with the aim to improve functioning before and after THA have usually little value. To improve functioning of each individual in his/her own environment before and after total hip arthroplasty (THA), professionals should change towards providing opportunities, tools and interventions that take
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In addition to a medical and functional preoperative assessment, we aimed to get insight into personal preferences and motivations of a person involved in a physical therapy intervention by use of a narrative analysis of the stories of a person before THA (Mrs. A, a 76 year-old woman with severe comorbidity), her daughter and her physiotherapist. Mrs. A was mainly motivated by her will to do enjoyable social activities and stay independent. Although she has the competence to try her best to undertake those activities that make her proud, her pain and physical limitations were anti-competences that motivated her to attend health care. Although the physical therapist seemed to be aware of these personal participation goals, her main focus was on improving and evaluating functions and activities. The daughter also wanted her mother to be able to do enjoyable activities and did not see herself as an informal