"I was considering surgery because I believed that was how it was treated": a qualitative study on willingness for joint surgery after completion of a digital management program for osteoarthritis.

Anna Cronström, Leif E Dahlberg, Håkan Nero, Catharina Sjödahl Hammarlund

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Abstract

OBJECTIVE: To explore, using a qualitative approach, reasons for patients' continued willingness or their shift in willingness for total joint replacement (TJR) surgery, following participation in Joint Academy, a Swedish, digital, non-surgical treatment program for osteoarthritis (OA).

DESIGN: Nineteen patients with hip or knee OA were interviewed after finishing their first six weeks in the treatment program, using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using a systematic text condensation method.

RESULTS: Analysis of the interview data revealed three main categories of reasons provided for the participants' decisions regarding surgery: 1) Various reasons for participating in Joint Academy with three sub-categories: (a) longstanding pain affects daily life, (b) last chance for improvement and (c) mandatory treatment to be eligible for TJR; 2) Willingness for TJR following treatment, which included four sub-categories: (a) surgery - the last resort, (b) reduced pain and improved functioning, (c) no perceived improvements after treatment, and (d) trust in healthcare providers; and 3) Expectations of TJR. The shift in willingness towards or away from TJR was mainly due to the perceived success of Joint Academy in improving their functioning.

CONCLUSION: Several patients reconsidered their options and had changed their attitude to TJR after participation in a digital program aimed at reducing OA symptoms and improving functioning. These results highlight the importance of providing patients with adequate information about non-surgical management options to facilitate shared decision-making, and possibly reduce the need for surgery.

Original languageEnglish
Pages (from-to)1026-1032
Number of pages6
JournalOsteoarthritis and Cartilage
Volume27
Issue number7
DOIs
Publication statusPublished - 2019

Swedish Standard Keywords

  • Health Sciences (303)

Keywords

  • Non-surgical management
  • digital treatment program
  • osteoarthritis
  • qualitative
  • surgery
  • total joint replacement

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