Factors That Influence The Decision To Go Ahead With Total Joint Arthroplasty: A Qualitative Investigation With A Sub-Analysis On The Effects Of Socio-Economic Status On The Decision-Making Process.
(2013) Factors That Influence The Decision To Go Ahead With Total Joint Arthroplasty: A Qualitative Investigation With A Sub-Analysis On The Effects Of Socio-Economic Status On The Decision-Making Process., no. 87.
Total joint arthroplasty (TJA) is a cost-effective and generally accepted treatment for patients with end stage OA. However, variation in provision and also satisfaction with outcomes has emerged within the NHS. Shared decision-making (SDM) could potentially counteract these problems by helping shape realistic expectations. In order to incorporate SDM into the decision-making process it is important to understand what influences patients' decisions to go ahead with the TJA. In addition, literature is lacking regarding differences in this process between patients from different SES, which could also contribute to the SDM process. As such, this study sought to investigate what influences patients' decisions to go ahead with TJA. In addition, this study aimed to examine whether there were differences between socio-economic status in this decision making process. Data were collected using in depth semi-structured interviews with a purposeful sample of participants (n=7) with OA awaiting TJA. A two-part analysis of the data was undertaken using an Interpretative Phenomenological Approach. Five main themes, along with associated subthemes emerged from the first part of the data analysis. These were: symptoms, opinions of others, experiences of surgery, social impact and the surgery itself. Preliminary differences also emerged from the second part of the data analysis with regard to the effect of SES on decision-making. These were the level of activation of the individual within the decision- making process and also the level to which the participants felt informed with regard to the surgery. The results support current understanding that the decision-making process is very individual and complex. They provide evidence that there are many factors that healthcare professionals must be aware of in terms of incorporating SDM into the decision-making process. In addition, tentative conclusions can be made that there are preliminary differences in the decision-making process that are dependent on SES. Further research in this area is indicated by these findings. However, healthcare professionals need to be aware of these in order to provide appropriate information and support to shape realistic expectations and therefore improve satisfaction with outcomes.