Tsai-Yun Hsiao

National Taipei University of Nursing and Health Sciences, Taiwan

Abstract Title: Tracing the Development of Nursing Knowledge on Postoperative Quality of Life After Total Knee Arthroplasty: A Milestone Theory-Informed Review

Biography:

Tsai-Yun Hsiao is a doctoral student and lecturer in nursing. She is currently affiliated with the National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, and Chia-Jen College of Nursing and Health Sciences, Chiayi, Taiwan. Her research interests include cancer nursing, gerontological nursing, and the development of nursing knowledge related to quality of life and postoperative care. Her doctoral work focuses on theory-informed analyses of nursing practice and the integration of patient-centered approaches to enhance quality of life among older adults with chronic illness and postoperative recovery needs.

Research Interest:

Background: Total knee arthroplasty (TKA) is an established intervention for advanced knee osteoarthritis, with postoperative quality of life (QoL) increasingly recognized as a critical indicator of recovery. Although a substantial body of research has examined clinical and functional outcomes after TKA, the evolution of nursing knowledge related to postoperative QoL has not been systematically examined.
Purpose: The purpose of this study was to analyze the development of nursing knowledge concerning postoperative quality of life in patients undergoing TKA, using milestone theory to identify key conceptual shifts in nursing research and practice over time.
Methods: A theory-informed literature review was conducted, including publications related to TKA and quality of life from 1963 to 2023. Milestone theory was applied as an analytic framework to examine changes in outcome conceptualization, care priorities, and nursing interventions, and to delineate distinct stages in the development of nursing knowledge.
Results: Five major milestones were identified. Early literature focused predominantly on biomedical and surgical outcomes, with quality of life implicitly defined through pain relief and functional restoration. Subsequent stages reflected an expanding recognition of patient-reported outcomes and psychosocial dimensions of recovery. From the early 2000s onward, nursing research increasingly emphasized rehabilitation-focused interventions, perioperative continuity of care, and patient education. In the most recent milestone, technology-enhanced and patient-centered approaches emerged as central strategies for supporting postoperative QoL, particularly during the post-discharge recovery period.
Conclusions: This milestone theory–informed review demonstrates that nursing knowledge on postoperative QoL after TKA has evolved toward a holistic, patient-centered recovery framework. By articulating this developmental trajectory, the study clarifies nursing’s contribution to redefining postoperative quality of life and provides a conceptual foundation for future nursing research and the design of integrated postoperative care interventions.