Establishing a hierarchy of total knee arthroplasty patients' goals and its congruity to health professionals' perceptions: a cohort study.
knee arthroplasty
osteoarthritis
patient expectation
shared decision-making
Journal
ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634
Informations de publication
Date de publication:
10 Dec 2023
10 Dec 2023
Historique:
revised:
23
11
2023
received:
16
09
2023
accepted:
25
11
2023
medline:
10
12
2023
pubmed:
10
12
2023
entrez:
10
12
2023
Statut:
aheadofprint
Résumé
To formulate a hierarchy of primary goals of patients prior to total knee arthroplasty (TKA) and evaluate the agreement between patients and health professionals regarding this hierarchy of patient goals. The five most important goals for each of 110 consecutive patients booked for total knee arthroplasty between June and October 2019 were identified. Goals were grouped into themes and then a hierarchy formulated. This hierarchy was randomized and provided to 94 health professionals, including orthopaedic surgeons (n = 49), rheumatologists (n = 16), physiotherapists (n = 16) and general practitioners (n = 13). These health professionals ranked the provided goals based on their belief of what was most important to patients. Ten overarching goals were identified, with the five most important goals to patients being improving mobility, reducing knee pain, improving daily tasks, participating in social & leisure activities and regaining knee range of motion. Health professionals ranked these goals highly similar to patients with the exceptions being that health professionals ranked quality of life near the top of the hierarchy (much higher than patients) and ranked improving mobility in the bottom half (much lower than patients). Ranking of these goals was similar between each health professional group. Pain and mobility are the most important goals to patients, with health professionals correctly identifying these as such. However, health professionals ranked quality of life higher, and mobility lower in the hierarchy than patients. This incongruity should be considered by health professionals when educating and communicating treatment outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
To formulate a hierarchy of primary goals of patients prior to total knee arthroplasty (TKA) and evaluate the agreement between patients and health professionals regarding this hierarchy of patient goals.
METHODS
METHODS
The five most important goals for each of 110 consecutive patients booked for total knee arthroplasty between June and October 2019 were identified. Goals were grouped into themes and then a hierarchy formulated. This hierarchy was randomized and provided to 94 health professionals, including orthopaedic surgeons (n = 49), rheumatologists (n = 16), physiotherapists (n = 16) and general practitioners (n = 13). These health professionals ranked the provided goals based on their belief of what was most important to patients.
RESULTS
RESULTS
Ten overarching goals were identified, with the five most important goals to patients being improving mobility, reducing knee pain, improving daily tasks, participating in social & leisure activities and regaining knee range of motion. Health professionals ranked these goals highly similar to patients with the exceptions being that health professionals ranked quality of life near the top of the hierarchy (much higher than patients) and ranked improving mobility in the bottom half (much lower than patients). Ranking of these goals was similar between each health professional group.
CONCLUSION
CONCLUSIONS
Pain and mobility are the most important goals to patients, with health professionals correctly identifying these as such. However, health professionals ranked quality of life higher, and mobility lower in the hierarchy than patients. This incongruity should be considered by health professionals when educating and communicating treatment outcomes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.
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