TY - JOUR
T1 - A qualitative analysis of decision-making for total knee replacement in patients with osteoarthritis
AU - Suarez-Almazor, Maria E.
AU - Richardson, Marsha
AU - Kroll, Tony L.
AU - Sharf, Barbara F.
PY - 2010/6
Y1 - 2010/6
N2 - OBJECTIVE: Variation in the utilization of total knee arthroplasty (TKA) for patients with osteoarthritis has been well documented. Conceivably, patient preferences may play a major role in these differences; however, this has not been adequately assessed. The purpose of this study was to conduct a qualitative analysis of decision-making factors influencing preferences for TKA in patients with knee osteoarthritis. METHODS: We conducted 6 focus groups of patients with knee osteoarthritis from diverse ethnic backgrounds attending primary care clinics affiliated to the largest private outpatient institution in Houston, TX. All groups were lead by race-concordant facilitators. The group discussions were centered on factors considered to be important in the decision-making for TKA. Thematic analysis was conducted, using a grounded theory approach aided by qualitative software. RESULTS: Several themes emerged from the groups' discussions. Positive and negative personal experiences played a major role in decision-making. Generally, participants had good expectations about improved function and quality of life, but a number of fears were identified, the most prevalent being fear of a lengthy recovery, followed by fear of complications and of anesthesia. Additional emerging themes included trust in surgeon, financial concerns, and worries about general health. CONCLUSIONS: The attitudes and beliefs of patients with knee osteoarthritis about TKA are largely based on personal experiences, expectations, and fears, and they are largely influenced by their close social environment. These findings emphasize the need for open doctor-patient communication around individual experiences to achieve satisfactory shared decision-making for TKA.
AB - OBJECTIVE: Variation in the utilization of total knee arthroplasty (TKA) for patients with osteoarthritis has been well documented. Conceivably, patient preferences may play a major role in these differences; however, this has not been adequately assessed. The purpose of this study was to conduct a qualitative analysis of decision-making factors influencing preferences for TKA in patients with knee osteoarthritis. METHODS: We conducted 6 focus groups of patients with knee osteoarthritis from diverse ethnic backgrounds attending primary care clinics affiliated to the largest private outpatient institution in Houston, TX. All groups were lead by race-concordant facilitators. The group discussions were centered on factors considered to be important in the decision-making for TKA. Thematic analysis was conducted, using a grounded theory approach aided by qualitative software. RESULTS: Several themes emerged from the groups' discussions. Positive and negative personal experiences played a major role in decision-making. Generally, participants had good expectations about improved function and quality of life, but a number of fears were identified, the most prevalent being fear of a lengthy recovery, followed by fear of complications and of anesthesia. Additional emerging themes included trust in surgeon, financial concerns, and worries about general health. CONCLUSIONS: The attitudes and beliefs of patients with knee osteoarthritis about TKA are largely based on personal experiences, expectations, and fears, and they are largely influenced by their close social environment. These findings emphasize the need for open doctor-patient communication around individual experiences to achieve satisfactory shared decision-making for TKA.
KW - Osteoarthritis
KW - Patient education
KW - Qqualitative research
KW - Total joint replacement
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U2 - 10.1097/RHU.0b013e3181df4de4
DO - 10.1097/RHU.0b013e3181df4de4
M3 - Article
C2 - 20414128
AN - SCOPUS:77953127483
SN - 1076-1608
VL - 16
SP - 158
EP - 163
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
IS - 4
ER -