A Cronström1, L E Dahlberg2, H Nero3, C S Hammarlund4. 1. Orthopedics, Department of Clinical Sciences, Lund University, Lund, Sweden. Electronic address: anna.cronstrom@med.lu.se. 2. Orthopedics, Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Orthopedics, Skåne University Hospital, Lund, Sweden. 3. Orthopedics, Department of Clinical Sciences, Lund University, Lund, Sweden; Joint Academy Inc., Malmö, Sweden. 4. Department of Health Sciences, Lund University, Lund, Sweden; The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
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 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.
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.
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