Trends in Psychological Well-being and Resilience Following Knee Replacement Surgery in Older Adults: A Longitudinal Study

Abstract

Background: Knee osteoarthritis is a prevalent condition among the elderly, often necessitating total knee replacement surgery, which can impact psychological well-being and resilience during recovery. Understanding the trajectory of these psychological factors is essential for optimizing postoperative care and promoting successful aging. Objectives: This longitudinal study aimed to evaluate trends in self-assessed psychological well-being and resilience among elderly patients following knee replacement surgery. Methods: This research is a longitudinal study. A total of 432 elderly adults (aged 60 - 74 years) undergoing unilateral or bilateral knee replacement surgery at Shafa Yahyaian Hospital, Iran, were assessed at discharge, one month, and three months post-surgery. Psychological well-being was measured using the Reef Psychological Well-being Questionnaire, and resilience was assessed by the Brief Resilience Scale. Data were analyzed using repeated measures ANOVA and other appropriate statistical tests. Results: Psychological well-being significantly improved from discharge to one month and three months post-surgery (P < 0.001), with no significant difference between the one- and three-month assessments. All six dimensions of psychological well-being (autonomy, environmental mastery, personal growth, positive relationships, purpose in life, and self-acceptance) demonstrated significant positive changes over time, except for purpose in life, which showed a different pattern. Resilience scores also increased significantly over time, peaking at three months post-surgery (P < 0.001). No significant associations were found between psychological measures and demographic characteristics such as age, gender, or education. Conclusions: Psychological well-being and resilience improve significantly during the first three months following knee replacement surgery in elderly patients. These findings underscore the importance of integrating psychological assessments and resilience-building strategies into postoperative nursing care and discharge planning to support holistic recovery and healthy aging.