Defense Date


Graduation Date

Fall 2004


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Linda Goodfellow

Committee Member

Kathleen Gaberson

Committee Member

Lynn C. Simko


elderly, qualitative, surgery, total knee arthroplasty


Patients experiencing postoperative pain are at an increased risk for developing life-threatening complications. Effective interventions for pain relief exist, but are under- utilized. The reasons for the under use of interventions need to be identified so that changes in nursing practice can occur. The purpose of this study was to increase the understanding of the postoperative pain experience following total knee arthroplasty from elderly patients' perspective. Hermeneutic phenomenology was used to guide this study. Fifteen patients, nine women and six men, who had total knee arthroplasty participated in this study. Ages ranged from 66 to 86 years. Purposeful suffering is the pattern that described the meaning of the participants' postoperative pain experience. Purposeful suffering is an acceptance of the postoperative pain and a willingness to endure the pain in order to achieve better mobility with little or no pain. The common experiences of the participants emerged in three themes: anticipating pain, living the pain, and managing the pain. Participants believed that pain was a necessary experience following surgery. Participants trusted their nurses to know how to best care for them following surgery and relied on the nurses to manage their pain. Participants' lack of knowledge about postoperative pain combined with their trust and reliance on nurses for pain management resulted in participants' suffering with postoperative pain. The suffering was purposeful for the participants because they believed that the result of enduring the pain would be a healed knee. Nurses need to evaluate patients' beliefs about postoperative pain so that misconceptions can be resolved. Understanding the experience of pain from the elderly patient's perspective following total knee arthroplasty provided new insight into the postoperative pain experience.