"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. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Cronström, A.; Dahlberg, L.E.; Nero, H.; Hammarlund, C.S.
• Is Part Of: Osteoarthritis and cartilage. Volume 27:Issue 7(2019)
• Page Start: 1026
• Page End: 1032
• Publication Date: 2019-07
• Subjects: Non-surgical management -- Osteoarthritis -- Qualitative -- Surgery -- Total joint replacement -- Digital treatment program; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Arthrose -- Périodiques; Articulations -- Maladies -- Périodiques; 616.7223005
• DOI: 10.1016/j.joca.2019.04.004
• Languages: English
• ISSNs: 1063-4584

Abstract

Summary: 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 6 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 total joint replacements (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.